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New mental-health law to start
Insurance industry must offer equal coverage
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Published: July 1, 2008
RALEIGH
Starting today, insurance companies in North Carolina must provide the same level of coverage for some mental illnesses that they do for physical ailments.
That means that someone being treated for depression or schizophrenia can no longer be charged a higher co-payment (or face other inequities in coverage) than someone being treated for diabetes or a broken arm.
Mental-health advocates have long pressed to have the principle of "mental-health parity" enshrined in law, and last year, the N.C. General Assembly passed a law that requires insurers to treat nine common mental conditions on par with physical conditions. The law takes effect today and applies whenever a new group insurance contract is signed.
The law will make it easier for people to get therapy or other types of low-level treatment before a mental illness becomes severe, advocates say.
"The things that we've been preaching -- as far as early intervention, prevention, all those things that we've heard for so long on the physical-health side -- we're now going to get to see them on the mental-health side," said John Tote, the executive director of the Mental Health Association in North Carolina.
Not all workers will be affected. Employers that are "self-insured" -- such as large corporations that pay for insurance out of pocket -- are covered by federal, not state, law and do not have to comply with the new mandate. About half of the state's workers work for self-insured companies.
When the law was making its way through the state legislature last year, some advocates for business expressed concern that the mandate would raise the cost of buying insurance.
Experts said yesterday that there is likely to be a minor initial increase in health-insurance rates after the law takes effect.
"There are costs, obviously, associated with this mandate, but we're anticipating it to be less than half of 1 percent," said Lew Borman, a spokesman for Blue Cross and Blue Shield of North Carolina.
Tote said that greater access to preventive mental-health care will help reduce costs in the long run. In other states with laws on mental-health parity, the mandate has not caused large increases in health-insurance costs.
The nine mental conditions covered by North Carolina's law are bipolar disorder, major depressive disorder, obsessive compulsive disorder, paranoid or other psychotic disorders, schizoaffective disorder, schizophrenia, post-traumatic stress disorder, anorexia nervosa and bulimia.
Other conditions -- such as autism or attention-deficit disorder -- are not guaranteed equal coverage.
■ James Romoser can be reached at 919-833-9056 or at jromoser@wsjournal.com.
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