Susan Busch, a health economist and professor in the Yale School of Public Health, delivered the latest lecture in the Edward Zigler Social Policy Lecture Series Friday on private insurance policies for the coverage of mental illness.
Busch’s talk, titled “The Effect of State Parity Laws on Children with Mental Health Care Needs,” presented preliminary data analyzing whether state parity laws reduce the financial burden on families of privately insured children with mental health conditions and whether they help such children receive health care.
Parity legislation attempts to make insurance companies treat mental health care needs with the same standards as general health care needs. Currently, Busch said, some insurance plans allot different amounts of coverage for general and mental health care, including the number of times a patient may visit a doctor. Some insurance companies, she said, also require higher cost-sharing for mental health care expenses.
Busch said that because the paper has not yet been published, the results are only preliminary. Using data from the 2000 State and Local Area Integrated Telephone Survey of Children with Special Health Care Needs, however, Busch’s preliminary results indicate that families in states with parity laws have reduced financial burden compared to families in states without parity laws.
Busch said studies in the 1970s showed that increased cost-sharing controlled the more elastic demand for mental health care, taken as an indication that patients did not value mental health care.
“We have a very different health care market now,” she said. “In an era of managed care, this rationale is less valid.”
Busch’s data were limited by the specific questions asked in the survey and the inability to identify insurance plans exempt from state parity laws. She said her findings suggest that further work needs to be done on the potential financial benefits for families with a child with a mental illness.
Some audience members agreed with Busch that the area merits further study.
“It just seems like there hasn’t been a lot of work in this area, and it’s really important,” Jennifer Titus EPH ’07 said. “It could really impact society as a whole.”
Others audience members said they remained skeptical that parity laws actually benefit children with mental health care needs.
“I wasn’t really convinced by her,” Zigler Center fellow Mikle South said.
Limited parity legislation has been passed, but with little real effect, Busch said. The federal government passed the Mental Health Parity Act in 1996, and many state laws mimic this legislation. But Busch said such laws are merely symbolic.
Previous research on state parity laws have found that they had little effect, Busch said.
“This research differs from all previous research in that we look at children specifically and also that we look at measures of financial burden,” Busch said.
She said some insurance companies also limit mental health care coverage to dissuade those with higher expected costs from enrolling.
“They don’t want to attract people with mental [health care] needs, so it’s a race to the bottom,” Busch said.