A proposed amendment to the Health Insurance Reform Act would have required health plans to provide mental health benefits comparable in cost and service limits to those provided for physical illness or injury.
Although this federal legislation was defeated, 19 states have adopted similar statutes, known as mental health parity laws.
In Ohio, former Democratic Rep. Charleta Tavares failed to garner support for the numerous parity bills she sponsored before leaving office last year.
Rep. Lynn Olman, R-Maumee, an insurance agent and small business owner for 25 years, hopes that his position as an insider in these groups, traditional opponents of health-care mandates, will help mental health parity gain political momentum.
"This is not a 'feel-good' bill," Olman says. "It's not something that would just be nice to do if we had a billion extra dollars. It makes economic sense for everyone. When I get face-to-face with people, I can show them that."
Olman's bill is more aggressive than Tavares', attempting to gain comparable coverage for all mental illnesses, as well as for substance abuse treatment. Tavares' version sought parity only for serious mental illnesses and those for which a biological cause has been discovered.
It contained no provision for substance abuse treatment. But Olman thinks that mental illness and substance abuse are too closely linked to separate.
"If mental illness is not properly treated, individuals often self-medicate with alcohol or drugs," Olman says. "We have to treat both to cure either."
Olman also points to the low cost of including substance abuse treatment in this bill. He predicts that the bill will increase spending on mental health benefits by 3.4 percent while money spent on substance abuse treatment will increase by only .2 percent.
The bill's opponents, however, claim that the cost of a mental health parity bill, eventually borne by employers and workers, will be significantly more. The Association of Private Pension and Welfare Plans, an organization that lobbies against the regulation of benefit plans, commissioned two studies to estimate the impact of parity laws on mental health spending. Both predicted increases of well over 8 percent, with one contending that an 11.4 percent increase is possible.
And, according to the Buckeye Institute for Public Policy Solutions, a group dedicated to expanding free market ideals, HMOs and insurance companies will raise premiums to recoup these increased expenses. In their scenario, 70,000 Ohio workers who now have health insurance no longer will be able to afford the higher premiums.
Olman disagrees, noting not only that these numbers are skewed, but also that comprehensive mental health benefits will reduce spending in other parts of Ohio's health-care system.
"In other states with this legislation, we've seen an initial spike in mental health expenditures, but then overall costs decrease," he says. "Fewer people visit the emergency room, which is one of the most expensive components of the entire health-care system, when they are receiving proper treatment for mental illnesses."
Dr. Melvyn Nizny, a Cincinnati-based psychiatrist and president-elect of the Ohio Psychiatric Association, believes that an increase in the utilization of mental health resources will cut health-care costs in other ways as well.
"Good mental health histories can often reduce the need for expensive tests by guiding doctors towards the possible causes of a physical affliction," Nizny says.
Both Olman and Nizny urge businesses and health insurance companies to examine the issue of cost in a broader context.
"If people do not receive the treatment they need, problems come out in other areas — absenteeism and inefficiency at work, marital strife and divorce, crime, unemployment, homelessness," Nizny says. "These all cost business and society a tremendous amount of money."
Even though the legislative records of both House Speaker Jo Ann Davidson, R-Reynoldsburg, and Senate President Richard Finan, R-Cincinnati, indicate a tendency to support the insurance industry and business community, Olman remains optimistic about the bill's chances.
"We are gaining co-sponsors in the House and are close to signing on a sponsor for similar legislation in the Senate," he says. "Our goal right now is to educate legislators on the benefits of this bill."
