Would Require Public Health Insurance Providers to Cover Mental and Nervous Disorders, Alcohol and Substance Abuse as Any Other Medical Illness
TRENTON – A bill sponsored by Senators Joseph F. Vitale and Bob Gordon, which would require public health insurance providers to cover the treatment of mental and nervous disorders, alcoholism and substance abuse under the same terms and conditions as other medical illnesses was approved today by the Senate Budget and Appropriations Committee.
“Long ago, we established that mental health disorders and drug and alcohol dependencies should be treated as diseases, unfortunately some health insurers in the state still do not treat these illnesses with the same regard as non-mental health disorders, and often block and limit access to treatment that would manage or cure them,” said Senator Vitale, D-Middlesex. “By requiring that the state’s two largest health plans for public employees get with the times and treat all illnesses the same whether of the mind or the body, we can ensure that mental health and substance abuse treatment is available to many of those who need it.”
The bill, S-1253, would expand mandated health insurance coverage for the treatment of mental and nervous disorders and substance and alcohol abuse disorders under the State Health Benefits Plan (SHBP) and the School Employee Health Benefits Program (SEHBP).
The bill would require that insurance providers participating in the public health insurance plans provide coverage for all mental and nervous disorders included in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, regardless of whether or not the disease is biologically-based or not, under the same terms and conditions as provided for any other illness under the health insurance policy. Current law only requires that a health insurance contract provide coverage for biologically-based mental illnesses, such as bipolar disorder or schizophrenia, as opposed to non-biologically-based mental illnesses, such as Post Traumatic Stress Disorder (PTSD).
The bill would also require parity when it comes to the treatment of alcoholism and other substance-use disorders under the same terms and conditions applied to other diseases or illnesses.
“Treatment is available to help those with mental illnesses, such as Post Traumatic Stress Disorder, or alcohol or substance abuse disorders to improve their lives,” said Senator Gordon, D-Bergen and Passaic. “It is ridiculous that in this day in age, when we are widely aware of these treatment options, that health insurance companies do not treat these diseases and illnesses in the same regards as biologically-based disorders. This legislation is about doing the right thing for those insured under the State Health Benefits Plan and the School Employee Health Benefits Program who are affected by these disorders, so they can get the treatment and care they need to get and stay healthy.”
The bill sponsors noted that the change in law is consistent with other federally-mandated mental disorder and substance abuse parity laws, including the Affordable Care Act (ACA) and the Mental Health Parity Act of 1996 and the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). Under these three laws, if an insurer covers both mental health and medical and surgical benefits, they are required to do so in compliance with parity requirements similar to what’s in Senators Vitale and Gordon’s bill.
Both lawmakers added that since the recent tragic shooting in Newtown, Connecticut, there has been an increased call for better mental health coverage for individuals suffering from mental illness. During a recent media interview, Governor Chris Christie noted that the “stigma about mental illness treatment in this country,” serves as contributing factor in gun violence.
The bill was approved with a vote of 11-0-2. It now heads to the full Senate for consideration.