Despite several federal and state laws passed in the past few decades to ensure that health insurance companies cover physical and mental health equally, many people still They are not getting the mental health treatment they need. Now Santa Clara County wants to join the fight for mental health equity.
As recently as 2020, the state Legislature sought to strengthen the California Mental Health Parity Act, first passed in 1999. The latest bill, sponsored by Sen. Scott Wiener (D-San Francisco), expands the types of medically necessary treatments and treatments for mental illness. Illnesses (including substance use problems) that health insurance companies must cover. The previous law only covered treatment for nine serious mental illnesses.
But despite bold promises, patients are still falling through the cracks, said a mental health advocate who questioned whether the agency was enforcing the new law in a May letter to the state’s Department of Managed Care. pointed out.
“This is a medical issue, plain and simple,” said Santa Clara County Supervisor Joe Simitian. “If someone shows up with a broken arm, insurance will cover it. If someone shows up needing mental health care, there’s no question in the fact that that person will get the help they need. Unfortunately, That is not the case today. It is long past time to think seriously about this issue.”
Earlier this month, Simitian and Supervisor Cindy Chavez issued a letter of introduction urging the county to intervene in the matter, whether by sponsoring state legislation or taking legal action to hold insurance companies accountable. submitted. The county has been in court over public health issues before, suing paint manufacturers and pharmaceutical companies over lead paint for fueling the opioid crisis, both of which resulted in large settlements in the county’s favor.
Simitian said litigation shouldn’t be the first choice, but the county “shouldn’t avoid litigation.”
“We will proactively roll up our sleeves and intervene with the legal system when necessary to ensure that insurance companies here in Santa Clara County and in California do the bare minimum required by law. We need to do that,” Simitian said.
The county attorney’s office plans to report on the matter to the Health and Hospitals Commission in mid-December and to the full Board of Supervisors in January.
Rebecca Basson, an attorney with the Silicon Valley Legal Foundation, said one of the biggest problems with the Mental Health Parity Act is that although it guarantees patients receive coverage for mental health treatment on par with physical health treatment, He said that quality is not necessarily guaranteed. Whether you can receive treatment or see a full health care provider.
Earlier this month, Kaiser Permanente agreed to a $200 million settlement with the state over patients experiencing long delays in receiving behavioral health treatment. They paid a $50 million fine and promised to correct “deficiencies in plan implementation and health behavior monitoring,” according to a press release from the California Department of Managed Care. The rest of his $150 million is Kaiser’s promise to improve behavioral health services over the next five years.
At the Law Foundation, Basson said many of his clients are unable to receive quality care in the outpatient setting and require hospitalization.
“People end up in hospital because the external systems are not set up well enough to support all the people who need care,” she says. “It’s great to say we have to provide equal care, but if we don’t have enough doctors and we don’t have enough resources to meet the needs and demands, we can’t actually provide care. We treat everyone equally just because we don’t have enough resources.”
Lovina Nimbalkar, executive director of the Santa Clara County Chapter of the National Alliance on Mental Illness, said one of the biggest problems when people can’t afford mental health care is that many insurance companies have coverage, so many therapists cannot afford it. and psychiatrists do not accept insurance. Companies reimburse them at much lower rates compared to other types of doctors.
Regarding the state’s expansion of the Mental Health Parity Act several years ago, Nimbalkar said he hasn’t seen any difference.
“There’s a lot of stigma around mental health and it’s not treated on the same level as physical illness,” she says. “I feel like people don’t understand that mental health means a chemical imbalance in the brain.”