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Volume 12 Number 133 News: Mental Health Requiring health plans to provide coverage for mental health equal to that of physical illnesses, as proposed in House legislation (H.R. 1424), could raise employers' health care contributions by as little as 0.1 percent, according to an analysis released July 10. The analysis by the consulting firm Milliman Inc., found that H.R. 1424 would increase per capita health insurance premiums by 0.6 percent, but that could fall to as little as 0.1 percent if plans adopted utilization management programs. The analysis was released at a hearing on mental health parity held by the House Education and Labor Health Subcommittee. It was the third House committee hearing on H.R. 1424, introduced by Reps. Patrick J. Kennedy (D-R.I.) and Jim Ramstad (R-Minn.). The Milliman analysis was prepared at the request of several mental health care groups, including the American Counseling Association, the Association for Addiction Professionals, and the American Association for Child and Adolescent Psychiatry. Milliman said the House bill would increase per capita health insurance premiums by 0.6 percent in 2008, or about $2.40 per member per month. If utilization management techniques were used, that could fall to 0.1 percent, or three cents per member per month, according to the analysis. Under the bill, facility-based behavioral health care services would increase 9.7 percent, while professional services would rise by 30 percent. Milliman said. The Senate mental health parity bill (S. 558), was passed by the Senate Health, Education, Labor, and Pensions Committee Feb. 14 (No. 31 HCDR 2/15/07 ). H.R. 1424, the Paul Wellstone Mental Health and Addiction Equity Act of 2007, would require that group health plans offering coverage to employers with more than 50 workers provide parity in coverage for mental health and substance-related disorders as for physical illnesses. Supporters are hoping the bills will be approved by the House and Senate before Congress leaves for its August recess. Business groups have rallied behind the Senate bill, saying it would be less costly than H.R. 1424. Supporters of the Senate bill also say it is the result of extensive negotiations among parity advocates, businesses, insurers, lawmakers, and other stakeholders. Utilization Management The Milliman report said the use of utilization management services would result in a 21.3 percent decrease in the use of facility-based services (inpatient hospital, partial hospital, and other outpatient hospital) and a 3.1 percent increase the use of professional services (diagnosis, evaluation, therapies, and medication management). Out-of-pocket costs for health plan members would fall 18 percent under the bill, Milliman said. For every 100,000 fully insured lives, member out-of-pocket costs would drop by $240,000 annually, the analysis said. Increasing benefits for behavioral health care services may result in cost offsets for other health care services, particularly visits to primary care physicians and emergency care services, the analysis said. Increasing benefits may also result in increased use of pharmaceuticals, it added. These possible effects were not included in the analysis, the analysis said. The analysis and testimony from the hearing are available.
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