2019 was a big year in the fight for mental health equity! Let’s take a closer look at six important game changers.
In Wit v. United Healthcare Insurance Company, 11 plaintiffs, on behalf of more than 50,000 patients, sued United Behavioral Health (UBH) for wrongfully denying mental health and addiction treatment coverage. In March 2019, a federal judge found that UBH, the largest managed behavioral health care company in the country, developed review criteria for evaluating the medical necessity of claims for outpatient, intensive outpatient, and residential treatment of mental health and substance use disorders that was inconsistent with generally accepted standards of behavioral health care, and wrongly influenced by a financial incentive to suppress costs. To amplify this landmark ruling, The Kennedy Forum sent a series of letters about Wit to state and federal officials, including state attorneys general, insurance commissioners, House Speaker Nancy Pelosi, and Senate Majority Leader Mitch McConnell. Awareness is spreading. In response to the ruling, California has already passed resolution ACR 98, which requires insurers to use medical necessity criteria that is consistent with generally accepted standards of care. And New York will now require that medical necessity criteria used by insurers must be approved by the state’s Office of Mental Health—and be fully consistent with generally accepted standards of care.
TWO: New State Parity Laws and Provisions
Colorado, New Jersey, Connecticut, and DC all enacted state parity laws in 2019, informed by The Kennedy Forum’s Model State Parity Legislation. Additionally, Illinois’ new parity law, which was passed in 2018 thanks to the leadership of The Kennedy Forum Illinois and its partners, became effective on January 1, 2019. The Kennedy Forum team was happy to work with dedicated advocates and policymakers, including Connecticut State Senator Matt Lesser and State Representative Sean Scanlon, Mental Health Connecticut, Mental Health Colorado, NCADD-New Jersey, and the American Psychiatric Association to help hold insurers accountable under the Federal Parity Law. New York also significantly strengthened its parity requirements in 2019 by enacting very successful parity provisions as part of its state budget.
THREE: Employers, Unions, First Responders, and Advocates Unite
‘Working Well’ was the theme of The Kennedy Forum’s 2019 Annual Meeting in Chicago. We were pleased to host leaders from Microsoft, Johnson & Johnson, Leidos, Lyft, The Hartford, Union Pacific Railroad, AFL-CIO, the International Union of Bricklayers and Allied Craftworkers, the International Brotherhood of Electrical Workers, International Association of Chiefs of Police, and more in powerful discussions about mental health. Topics included increasing access to care, holding health plans accountable for parity, and normalizing the conversation around mental health and addiction in the workplace.
FOUR: Launch of Mental Health for US
Mental Health for US, a nonpartisan educational initiative, was created to elevate mental health and addiction in policy conversations during the 2020 election cycle. The initiative, which is supported by more than 80 partner organizations, presents a comprehensive policy platform with three main focus areas: Prevention, Access and Intervention, and Recovery. Former U.S. Rep. Patrick J. Kennedy (D-RI) and former Senator Gordon Smith (R-OR) serve as co-chairs. Town hall events are taking place around the country to educate and inspire and voters. The next event is scheduled for January 13 in California. Learn more here. Sign the Mental Health for US statement of support here.
More than 70,000 Americans died of overdoses in 2017, yet insurers spent just 1% of their total health care reimbursement on substance use disorders—a decrease compared to two years earlier. New Milliman data also shows that insurers are by and large failing to address huge out-of-network utilization disparities between mental health/addiction and medical/surgical care for inpatient facilities, outpatient facilities, and office visits. This means more people are being forced to pay out of pocket for critical care. To encourage action around the new Milliman data, The Kennedy Forum, along with Congressman Jim Ramstad and the heads of NAMI and Mental Health America, submitted a letter to two committees calling for congressional hearings on mental health parity. We urged movement on these recommendations, which will increase access to care and hold insurers accountable under the law. Read Patrick J. Kennedy’s op-ed about the Milliman findings here.
SIX: Parity Goes Mainstream on Netflix
In the season opener of his popular Netflix show, Patriot Act, comedian and host Hasan Minhaj discussed the complexities of navigating insurance coverage for mental health care in America and provided a thorough—and humorous—explanation of parity. The Kennedy Forum’s Parity Registry website was promoted as a place where consumers can speak up about insurance denials. Since the show went live on November 10, we’ve had thousands of visits to ParityRegistry.org and hundreds of new complaints submitted. Watch the full episode here.
Thank you for your support this year. If you would like to contribute to The Kennedy Forum’s efforts, please consider a year-end donation through Facebook or our website.
Here’s to more game changers in 2020. Have a safe and happy New Year!
The Kennedy Forum