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What You Need to Know About the Wisconsin Parity Act
Because navigating the insurance plan landscape to determine eligibility and scope of benefit coverage can be somewhat confusing, the New Day Coalition created this brochure to help answer some important questions related to parity and how it might affect you. Should you still be unsure of your coverage after reviewing this brochure, please review your insurance policy coverage statement or contact the person at your company that handles employee benefits.
More Information About the Wisconsin Parity Act
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MHA Resource Explains Federal, State Parity Laws
After many years of hard work parity is now the law of the land at both the federal and state level in Wisconsin. But in order for people living with mental illnesses and addiction disorders to receive the full benefits of the laws, the laws must be implemented as envisioned by Congress and the Wisconsin State Legislature. This requires that consumers, family members, advocates and providers all understand what the laws require and what to do if you think they are not being implemented correctly.
A Web page by Mental Health America of Wisconsin provides information about the state and federal laws, how they interact, consumer rights and expectations under the law and what to do if you think someone is not receiving the services to which they are entitled. Mental Health America of Wisconsin also has a section on resources for employers on implementing parity in their health plans.
The Wisconsin Parity Act Closes Gaps in Federal Law
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| Several local experts and advocates have provided support on behalf of the legislation, including Joanne Grassman (pictured left with her daughter, Leslie Osman, who suffers from anorexia, a disease most health insurance policies traditionally have not covered [photo courtesy the Capital Times]). |
The Wisconsin Parity Act is an important bill that will provide equitable mental health and substance use disorder treatment benefits for many of the 700,000 Wisconsin residents left uncovered by the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, P.L. 110-343, which does not protect insured individuals who work in businesses with 50 or fewer employees.
The Wisconsin Parity Act will require most group health plans in Wisconsin to provide mental health and substance use disorder benefits at parity levels. This new law will increase treatment for hundreds of thousands of people in Wisconsin, saving lives and lowering costs.
Read more here.
The Wisconsin Parity Act Recognizes the Concerns of Small Businesses
An amendment to the bill allows employers with fewer than 10 employees to opt out of the parity provision. The amendment also permits larger employers who can show that parity has increased their insurance costs by two percent to opt out as well.
Wisconsin’s small businesses cannot afford the costs of untreated mental illness and substance use disorder. For a minimal investment, parity will save billions of dollars in reduced sick days, increased worker productivity and decreased health care costs.
The Wisconsin Parity Act will NOT lead to a substantial increase in premium costs. A March 4, 2008 study by the Congressional Budget Office (CBO) of the law that became the Wellstone-Domenici Act—the most recent, authoritative, independent, expert analysis of parity’s economic impact on private-sector employers—found that parity would increase costs by less than one half of one percent of premium.
Several states have successfully enacted parity legislation! Those states have not seen significant increases in premiums and no significant increase in the number of businesses that have discontinued employee health coverage. In addition, businesses that offer health plans that include mental health and addiction coverage have experienced reductions in absenteeism, turnover and disability costs while at the same time showing increases in productivity.
Oregon Plan Finds Mental Health / Substance Use Disorder Treatment Highly Cost Effective Compared to Treatments for Other Medical Conditions
The Oregon Health Services Commission has ranked medical services for 680 conditions to show which are the most clinically effective and cost effective. Every year when the Oregon Legislature decides how much money to allocate for the health plan, analysts go down the list and decide how many of the conditions they can cover. Starting Oct. 1, 2009 they cover 503 of the 680 conditions.
Both medical / psychotherapy for use disorder or dependence of psychoactive substance (line number 5) and medical / psychotherapy for major depression, recurrent (line number 9) ranked ahead of medical therapies for type I diabetes (10), asthma (11) and hypertension (12). Medical psychotherapy for schizophrenic disorders (27) and treatment for bipolar disorders (32) are well above the cut line, and came in ahead of treatment epilepsy (36), rheumatoid arthritis (52), and acute and subacute ischemic heart disease, myocardial infarction.
Given what we know about the cost effectiveness of treatments for mental health and substance use disorders, why wouldn't we want them to be covered in a manner no more restrictive than the coverage for other conditions?
Webinar: Utilizing Mental Health Parity to Enhance Your Bottom Line
Featuring Jerry Halverson M.D., UW-Madison School of Psychiatry; and Jeff Kluever, Director of Risk Management, Journal Communications.
Kluever discusses Journal Communications' move to parity, and its findings that mental health / substance use disorder parity can help reduce employer costs. Watch here.
Successful Employer Implementation of the Federal Mental Health Parity and Addiction Equity Act
A publication of the Partnership for Workplace Mental Health, a program of the American Psychiatric Foundation. PDF
Download the full media log here (PDF).
Rep. Sandy Pasch Op-Ed: "Mental health parity needed"
We would never consider other types of "carve-outs" for physical health conditions, such as cardiac and pulmonary diseases, diabetes or orthopedic problems. We provide treatment for these illnesses because not doing so leaves people in pain, unable to function, to work and care for their families. However, many continue to perceive, and dismiss, mental illness and substance use as character flaws. This is reflected through the appalling lack of insurance coverage for treatment.
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The U.S. surgeon general reported that the indirect costs of mental illness imposed an estimated $79 billion loss on the U.S. economy in 1990. The costs to business of absenteeism, lost productivity and disability and unemployed insurance claims due to mental illness and addiction outweigh any costs associated with mental health and substance use treatment. Findings in the medical community note that untreated depression increases the costs and decreases the rates of recovery from heart disease, strokes, diabetes and other illnesses.
Read the full Op-Ed in the Milwaukee Journal Sentinel (PDF).
