One of the first bills to advance in the Iowa legislature would require that the insurance policies individual Iowans buy as well as the policies Iowa businesses provide their employees cover the costs of substance abuse treatment.
In 2005, the Iowa legislature voted to require companies that employ 50 or more workers — and which provide those workers with health care benefits — to begin covering treatment for “biologically-based” mental illnesses.
A bill which cleared a subcommittee in the Iowa House Thursday would not only require those policies to cover substance abuse treatment, but cover other mental illnesses that are not “biologically-based” — conditions like post-traumatic stress disorder, bulimia and anorexia.
Deanna Triplett, a lobbyist for the Iowa Behavioral Health Association, says getting treatment for post-traumatic stress or an addiction to drugs or alcohol should be a standard in an insurance policy. “We’re not asking for (legislators) to mandate leather seats, if you will,” Triplett says. “We’re asking you to mandate seatbelts.”
The Iowa State Association of Counties supports the bill. Linda Hinton, the group’s lobbyist, says county taxpayers often end up footing the bill for the mentally ill or those being treated for a drug or alcohol addiction as it’s expensive, it’s not covered by insurance policies and people can’t afford paying for it on their own.
“Counties spend a lot of money for services for persons with mental illness and substance abuse and we support full parity because we believe some of those costs should be borne by the private sector,” Hinton says.
Current law says Iowa’s smaller businesses — the ones with 49 or fewer employees — don’t have to obtain insurance policies for workers that cover “biologically based” mental illnesses. This new proposal, however, would require all businesses — regardless of size — to provide health care benefits that cover substance abuse and all mental illnesses.
Paula Dierenfeld, a lobbyist for the Federation of Iowa Insurers, says substance abuse treatment is very costly and some businesses quit providing health care benefits to their workers if the costs of policies rise. “Chances are, if they don’t currently have this kind of coverage they’ve chosen not to have it in their insurance plan because they can’t afford it,” she says. “By mandating this on small employers and individuals, you’re not making insurance any cheaper for them. You’re making it more costly for them.”
Dierenfeld says a study done by the Council for Affordable Health Insurance concludes insurance rates could go up between one and three percent if the bill being proposed becomes law. Representative Beth Wessel-Kroeschell (WEHS-ull kroh-SHELL), a Democrat from Ames, says while she worries about small businesses, that kind of increase seems reasonable when you consider taxpayers often have to pick up the tab because insurance companies haven’t.
“We have sections of prisons that are dedicated to people who are suffering from mental illness and I believe, in part, that’s because they didn’t have (insurance) coverage and they didn’t get services early on,” she says, “and I think this is a beginning point.” Insurance companies worry if this bill becomes law, legislators next will require insurance coverage for a wider range of childhood illnesses like attention deficit disorder.
Frank Stork of Wellmark Blue Cross and Blue Shield says the more conditions an insurance policy covers, the more expensive that policy is.
“And I’ve got to stress — that discourages people from buying insurance,” Stork says.