[NYAPRS Enews] PN: MH Parity Added to SCHIP, More Access to Care

[Matt Canuteson]

NYAPRS Note: The article below highlights last months expansion to the
State Children's Health Insurance Program (SCHIP).  The legislation,
signed by Obama, includes provisions aimed at increasing MH/substance
abuse care for millions of lower-income children. The expansion,
effective April 1st 2009, eliminated the longstanding SCHIP provision
that allowed states that administer the program to cover only 75 percent
of the cost of mental health care included in benchmark plans that each
state designates as models for SCHIP plans. The change requires that all
private-sector SCHIP plans comply with the Wellstone/Domenici Mental
Health Parity and Addiction Equity Act of 2008, which requires parity
coverage for MH care in employer-sponsored plans that offer mental
health coverage. 


MH Parity Mandate Added to SCHIP, More Children Access to Care


Rich Daly Psychiatric News March 6th 2009

 

The New Measure Replaces Longstanding Provisions In The Children's
Health Insurance Program That Limited Reimbursement For Mental Health
Treatment

President Barack Obama signed legislation last month that expands the
State Children's Health Insurance Program (SCHIP) and includes
provisions aimed at increasing mental health care, including for
substance abuse, for millions of lower-income children. 

Under the nearly $33 billion measure (PL-111-3), the number of children
eligible for SCHIP will increase from 7 million to 11 million. Moreover,
for the first time in its 12-year history, SCHIP will cover treatment
for mental illnesses at the same rate and on the same terms as it does
for nonpsychiatric disorders. The expansion becomes effective on April
1. 

The measure also raises the maximum income of the families whose
children can receive full matching funds from 200 percent of the federal
poverty level to 300 percent, or $52,800 for a family of three. 

The change thrilled mental health advocates. 

"The American Psychiatric Association continues to fight for mental
health equality, and we are especially pleased that this legislation
includes strong language that will strengthen and improve access to
mental health services, including substance abuse treatment services for
children," said APA President Nada Stotland, M.D. "Children's [good]
mental health is essential to their well-being, and access to mental
health care will enable children to play, learn, and grow into healthy
adults." 

The measure eliminated the longstanding SCHIP provision that allowed
states-which administer the program-to cover only 75 percent of the cost
of mental health care included in benchmark plans that each state
designates as models for SCHIP plans. The change requires that all
private-sector SCHIP plans comply with the Paul Wellstone and Pete
Domenici Mental Health Parity and Addiction Equity Act of 2008, which
requires parity coverage of psychiatric illness in employer-sponsored
plans that offer mental health coverage. 

Obama described the expansion of the program for the children of the
working poor as the first step in his plan to overhaul the nation's
health care system and expand access to insurance. 

"Providing health care to more than 10 million children through the
[State] Children's Health Insurance Program will serve as a down payment
on my commitment to ensure that every American has access to quality,
affordable health care," Obama said in a written statement. 

Coverage Hard to Find 

The impact of the change in SCHIP is significant because research has
found that while low-income children have much higher rates of mental
illness than those in higher-income families, only about 40 percent of
states offer full coverage of necessary services for children with
complex psychiatric illnesses. Up to 20 percent of children and young
adults may have a psychiatric illness at any given time, according to
the Department of Health and Human Services, which estimates that the
number of affected youth is between 7.7 million and 12.8 million. The
department also estimates that two-thirds of all youth with mental
illness are untreated. These children are at higher risk to fail at
school, have poor employment prospects, have contact with the juvenile
justice system, and are more vulnerable to suicide, according to David
Shern, Ph.D., president and CEO of Mental Health America. 

"Mental health care is a critical component of the range of services
that children need for healthy development," Shern said in a written
statement. 

Critics Blast Expansion 

Opponents of the measure included former President George W. Bush, who
twice vetoed nearly identical measures to expand SCHIP in 2007. Bush,
like many other opponents, argued that the expansion would bring many
privately insured children under the federal program, in part, because
it provides federal matching funds for children from families whose
income is up to 300 percent of the federal poverty level and are likely
already insured. Some estimates have put the number of such children at
about 2.4 million. 

Many Republicans also complained that the measure expands coverage to
include legal immigrant women who are pregnant and up to 600,000
children of legal immigrants. The previous law had set a five-year wait
before children of legal immigrants could qualify for SCHIP coverage.
Citizen children of illegal immigrants are eligible for SCHIP; however,
illegal adult and child immigrants are eligible only for emergency care
under Medicaid. 

Democratic leaders countered that most Americans support SCHIP expansion
and that it has become increasingly important as the economy worsens and
more people lose their jobs. 

Critics also objected to the expansion being funded by a 62-cent
increase in the federal excise tax on cigarettes, which brings the total
federal excise tax to $1.01 a pack. Opponents said cigarette taxes
should go to smoking-cessation programs, not children's health care. 

The federal funding for the program was set to run out on March 31, but
the new law extends federal support for five years. 

The SCHIP bill can be accessed by searching on HR 2 at
<http://thomas.loc.gov <http://thomas.loc.gov> >.

 

 

 

 

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