Patrick J. Kennedy Calls for Congressional Hearings After Disturbing New Data Raises Huge Red Flags About Insurers’ Likely Violations of Federal Parity Act While Opioid Crisis Swept Nation
- November 21, 2019
The following is a statement from former Congressman Patrick J. Kennedy in response to the latest report from independent actuarial firm, Milliman.
As U.S. life expectancy declined over the past three years, primarily due to overdoses and suicides, new Milliman data shows insurers failed to adequately cover lifesaving care. With the release of this report, no insurance company can honestly say it is doing enough to tackle the biggest public health crisis of our time. More than 70,000 Americans died of overdoses in 2017, yet insurers spent a paltry 1% of their total health care reimbursement on substance use disorders—a decrease compared to two years earlier.
The new Milliman data from 2016 and 2017 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 people are paying more out-of-pocket for mental health/addiction care than they are for medical care—largely because insurers continue to reimburse mental health/addiction providers at significantly lower rates than their primary care/specialist counterparts, causing those providers to stop accepting insurance altogether. Consequently, people are depleting retirement accounts and taking out second mortgages to cover costs on their own. Frustrated families are often forced to give up and just hope for the best.
This report clearly shows that the insurance industry looked the other way as Americans were dying at record rates. It is time for insurers to double down on their own efforts to comply with the law. Insurance companies should be aggressively investing in innovative technologies and services to help providers extend their reach beyond the traditional care infrastructure, reimbursing mental health and addiction treatment providers on par with other providers, and being transparent in parity reporting.
But the reality is, everyone needs to step up if we are going to curb this crisis! The new Milliman data is not only an indictment of insurers, it is an indictment of our nation’s employers and regulators as well. Pharmaceutical companies can’t bear the burden of the opioid crisis alone—insurers and other stakeholders have roles to play.
Employers and regulators should be demanding proof of compliance with the Mental Health Parity and Addiction Equity Act, which requires insurers to cover treatment for mental health and substance use disorders no more restrictively than treatment for illnesses of the body, such as diabetes or cancer. Additionally, families and advocates must speak up and put pressure on the system to change instead of waiting for government and industry leaders to do the right thing.
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, have submitted a letter to Chairman Frank Pallone of the House Energy and Commerce Committee and to Chairman Bobby Scott of the House Education and Labor Committee calling for congressional hearings on mental health parity. We urge the Committees to prioritize policy solutions, including these recommendations put forth by The Kennedy Forum, which will increase access to care and hold insurers accountable under the law.
Equality for those with mental health and substance use disorders is a matter of civil rights. The silence that pervades this space serves no one, as the data clearly shows.
Additional Parity Resources & Information from The Kennedy Forum
Affordable Mental Health Care? It’s Getting Even Tougher to Access—Kaiser Health News coverage of Milliman report. “The moment [insurers] make payment the same for brain illnesses as for any other illnesses, the sooner we’re going to get to people having the access to the treatment they need.” – Patrick J. Kennedy
ParityRegistry.org—A website where consumers can learn to file an appeal and/or register a complaint against their health plan after being wrongfully denied coverage for mental health or addiction treatment services.
ParityTrack.org—A website where policymakers, consumers, and media can track legislative, regulatory, and legal parity activities in all 50 states and at the federal level to monitor implementation and best practices.
DontDenyMe.org—A website that educates consumers and providers about patient rights under the Federal Parity Law and provides downloadable materials for use in patient settings.
Mental Health for US—a nonpartisan educational initiative focused on elevating mental health and addiction in policy conversations during the 2020 election cycle. The initiative is powered by a coalition of stakeholder groups from around the country dedicated to uniting the American people to make systemic, long-term change with civic engagement tools and resources.
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Just as President Kennedy rallied the nation to dream big and set audacious goals 50 years ago, The Kennedy Forum seeks to set a new standard for the future of health care in the United States.
Our mission is big, and the stakes are clear. We seek to unite the health care system, and rally the mental health community around a common set of principles: Fully implement the 2008 parity law, bring business leaders and government agencies together to eliminate issues of stigma, work with providers to guarantee equal access to care, ensure that policymakers have the tools they need to craft better policy, and give consumers a way to understand their rights.