Behavioral health coverage should be protected by law

Guest column by state Rep. Lisa Cutter
Posted 4/3/19

Colorado has one of the highest suicide rates in the nation. In 2017, a quarter of a million Coloradans said cost was the reason they did not get the mental health or substance use treatment they …

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Behavioral health coverage should be protected by law

Posted

Colorado has one of the highest suicide rates in the nation. In 2017, a quarter of a million Coloradans said cost was the reason they did not get the mental health or substance use treatment they needed. Because of this, Colorado families have given up custody so their children can get care. Mothers have gone bankrupt to treat their daughter’s addictions.

The need for mental health care knows no socio-economic bounds. Many families have insurance and pay monthly premiums, yet because their insurance denies payment for their care, they may have to pay a second time. And because there is a dearth of in-network providers from which to choose, or they are not able to be seen in a timely manner, Coloradans are going out of network seven times more often for mental health and substance use services than for physical care. When they are able to get mental health care, these providers are reimbursed at rates 30 percent lower than other health providers.

If you have more than one health condition, the situation worsens. Many Coloradans have both a substance use issue or developmental disability in addition to a mental health condition. These individuals do not get the care they need because of existing coverage loopholes, which frequently consider substance abuse or a development disability as the primary condition from which the mental health issues stems. This leads to denial of coverage for the mental health issue. These individuals must then get care in our emergency rooms or worse yet — our child welfare system or jails.

Two families in my life have experienced similar situations and seen their sons with mental health issues land in jail. Treating people as criminals rather than providing them the treatment they need is shameful. And it only increases costs to the system while leaving people in crisis. Consider this — the average cost of housing a level one offender in Colorado’s jails is more than $28,000 per year.

Federal and state parity laws require coverage for mental health or substance use conditions equal to that as for physical health conditions. Mental health already carries a stigma that often prevents people from seeking treatment. It is imperative that we equalize treatment, and thus help normalize mental health issues.

That is why I am working with Mental Health Colorado to sponsor a bill that would strengthen and enforce existing laws to protect individuals with mental health and substance use disorders. This bill will eliminate denials for mental health care because an individual also experiences another health condition, such as a traumatic brain injury or developmental disability. It will strengthen prevention and screening laws to shift our system towards early intervention. And it will eliminate loopholes in current laws so no more Coloradans fall through the cracks.

The World Health Organization recently released a study indicating that for every $1 invested in the United States to treat depression and anxiety, there is a $4 social return on investment. Modernizing our mental health coverage is not only fiscally responsible, it is also the morally right thing to do. Twenty percent of individuals reading this column right now have a diagnosable mental health condition. This bill is for you — to protect you and ensure that when you need help, the last thing you need to worry about is being denied coverage for the treatment you need.

Rep. Lisa Cutter is a member of the Colorado House of Representatives from the 25th district in Jefferson County. She was born and raised in Colorado.

Lisa Cutter

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