April 20, 2019


Gov. King’s skittishness about increasing health care costs any amount is understandable given the recent insurance-rate increases. However, to veto mental-health coverage without regard to the importance of the services provided but simply because there is a small cost directly expands the problem that health care coverage currently produces. Lawmakers, who showed strong support in both the House and Senate when this legislation was first approved, should override his veto.

LD 1627 would require coverage of mental illness only in the large-group market. The Bureau of Insurance estimates it would cost policyholders an additional four-tenths of 1 percent ($3 a month, on average), or something less than the rounding error in the typical contract increases. The bill includes coverage of residential treatment facilities and home health services and prohibits exclusion of mental health and substance abuse benefits because of a pre-existing condition. Its unstated message is as clear as the bill’s language: The distinction between the treatment of physical and mental health is a false one and the two should be given equal regard. Maine’s congressional delegation, by the way, is unanimous in cosponsoring federal legislation that would provide parity.

Mental health coverage saves money, which is only one reason the King administration has urged state workers to get treatment for depression when necessary. A federal study not long ago looking at the mental health benefits at American Airlines, AT&T, Delta Airlines, Eastman Kodak, General Motors and IBM came to the same conclusion. According to a report by the Washington Business Group on Health, the “employers provide general mental health and substance abuse benefits to the employees and their families because they are convinced that doing so is essential to the corporate ‘bottom line.’ … The costs of providing appropriate treatment for mental and addictive disorders must be measured in the larger context that also considers disability costs, employee absenteeism and lost productivity. Taking these into consideration, employers found that traditional benefit limitations were not cost-effective.”

LD 1627 would also save money by deappropriating funds from the Departments of Behavioral and Developmental Services and Human Services. These savings would come as people got the needed treatment through their private insurance, thereby keeping their jobs, avoiding destitution and then qualifying for state care. Gov. King said he doesn’t count these savings because employers might drop coverage altogether if premiums rise because of this bill. What General Motors and IBM found out, apparently, doesn’t apply in Maine.

Just as exempting coverage for broken legs or heart attacks would save premium money but make no sense, so too with exempting insurers from covering mental-health problems. Physical ailments are covered, people suffering because of them get treatment and, mostly, get better, returning to family and work and the rest of their lives. The bill vetoed by Gov. King requires in a limited way the same treatment for mental health. And certainly, health insurance is expensive and growing steeply in cost and just as certainly the many groups in Maine currently trying to lower costs will inevitably face the question of when and where to limit coverage for specific illnesses.

But exempting coverage for a range of mental illnesses because other kinds of illnesses now covered cost a lot adds no clarity, establishes no priorities and makes the current hodgepodge of coverage seem even more arbitrary. This is no way to build a health care system in Maine or even keep costs from rising. The majority of lawmakers knew this when they approved LD 1627; they should urge their colleagues to re-examine and support this legislation now.

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