Mental Health Parity
Issue Overview: For more than 20 years, the cost and availability of healthcare has remained the No. 1 problem for small business. On a national average, less than half of small business with less than 100 employees offers healthcare, as opposed to 98 percent of big businesses that do, according to studies by the Kaiser Family Foundation.
The leading culprit in this grim statistic are state governments across the nation that add more and more costly procedures (mandates) on to basic healthcare plans before they let insurers legally sell them. Quite simply, the more mandates, the costlier healthcare is to buy.
For the 2008 legislative session, a few bills have been introduced to create mental health parity. Specifically, the measures require an "all or nothing" mental health mandate on any size employer. If an employer chooses to provide mental health benefits in their health insurance plan for their employees, the benefit must be equal to the regular medical care in that plan. For example, if an employer allows employees to go to their family practitioner for unlimited visits, the employer would also be required to offer that same level of care for mental health.
On the other side, if an employer can not afford to offer mental health parity, they would be unable to offer modified mental health benefits to their employees. For example, if an employer wanted to offer limited mental health benefits where employees could schedule up to 20 visits during the benefit year, an employer could not offer that coverage unless there was a cap of 20 visits on regular doctor visits. Limiting visits with general practitioners isn't likely to be a reality; therefore, an employer would be required to make a very difficult choice: offering mental health parity or not offering mental health at all.
Often, bill supporters have claimed that health plans are not offering mental health benefits to employers (Senate Commerce Committee, March 3, 2004). Respectfully, we disagree with the proponents. Shopping around any of the healthcare plans in Arizona, it is quickly discovered that they offer varied levels of coverage to employers. Some plans offer very rich mental health benefits; while others offer limited benefits that still provide necessary basic coverage for employers and employees. The key is that health insurance carriers ARE providing different levels of mental health benefits without a government requirement, and small business owners are able to make a decision on which level of care they want and can afford to offer their employees.
NFIB Position: Small business owners disagree that mental health parity mandates and "either/or" coverage is the way to solve the mental health issues and the affordability problem. Typically, mandates increase the cost of healthcare and further the affordability crisis. Additionally, mandates take away a small business owner's rights to establish an insurance product that is most fitting for their employees' needs.
NFIB ballots have demonstrated the following:
- Should the Arizona Legislature declare a moratorium on new healthcare mandates? Seventy-five percent said YES.
- Should government require small business owners to offer mental health benefits? Eighty-three percent said NO.
Issue Status: All mental health parity bills did not proceed to the governor's desk for consideration. The issue is dead for the 2008 session.
