Oklahoma lawmakers seek mental health parity

Some Oklahoma lawmakers want health insurance companies to cover mental health and substance use disorders the same way they cover physical ailments.

Legislation introduced by state Sen. John Montgomery would help clarify whether insurers in Oklahoma meet federal requirements for parity in the health care industry. Increased transparency is being sought to ensure mental health and substance use treatment is given the same level of coverage as physical health.

“Basically, we’re just establishing reporting requirements at the Insurance Department for how these plans will be carried out,” said Montgomery, R-Lawton.

Senate Bill 1718 would task Oklahoma Insurance Commissioner Glen Mulready with ensuring all in-state health plans comply with a 2008 federal law signed by President George W. Bush that calls for financial parity.

Insurance companies that offer mental health or substance use disorder plans also would have to annually report to the Insurance Commissioner the process by which they determine the criteria for mental health benefits and the criteria for medical and surgical benefits.

The department would be required to make the reports public by June 1, 2021, and every June thereafter. Eight states have passed similar legislation.

“It’s a federal law but states have an important role to play in the implementation,” David Lloyd, with the Kennedy Forum said. “States are the primary regulators for many types of health insurance plans.”

The Kennedy Forum was founded in 2013 by former Congressman Patrick Kennedy, from Rhode Island. It works nationally to advocate for states to adopt legislative requirements like the ones currently being considered by Oklahoma’s Legislature.

Despite federal requirements, many states, and the country as a whole, still struggle to provide equal coverage for mental health and substance use treatment. This inequality can come in the form of fewer in-network physicians or unequal reimbursement rates for behavioral health compared to physical health.

For example, visits to out-of-network facilities for behavioral health occur at a higher rate than out-of-network physical health facilities, according to the Milliman Research Report, which examined disparities in mental health and physical health treatment.

Nationally, the rate of out-of-network visits for inpatient behavioral health centers is more than five times the rate for similar facilities focused on physical health care, according to the report.

In Oklahoma, the rate was more than six times higher.

But some people are pushing for change.

There is a growing emphasis on mental health statewide and nationwide, said House Majority Floor Leader Jon Echols, the House author of SB 1718.

“The reason I agreed to accept that bill is yes, we have to keep insurance costs down, but parity and transparency inside insurance contracts, I think, are bipartisan issues that everybody should be in favor of,” he said.

Many of the state’s health and mental health groups are backing SB 1718.

Sen. John Haste, R-Broken Arrow, also has backed the measure, saying it could truly save lives. Oklahomans won’t have to put off mental health treatment because it’s not covered by their insurance, Haste said.

“If we go down this path, and a doctor recognizes that someone needs treatment or help related to mental health suicides and so forth, it’s not always covered,” he said. So, at the end of the day, they’re not going to get help.”

The bill should not result in costs to the state or insurance companies, Montgomery said.

SB 1718 recently passed out of committee and now heads to a full vote of the Senate. The title is off the bill, which is legislative jargon to indicate the measure is still being tweaked.