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Assembly Approves Oliver & Wagner Measure to Ensure Better Coverage for Mental Health Treatment

Measure Urges Christie to Forego Exemptions that Allow State to Offer Less Coverage for Mental Health Treatment Than Other Illnesses

The full Assembly on Thursday approved a measure sponsored by Assembly Speaker Sheila Y. Oliver and Assemblywoman Connie Wagner to help boost access to mental health treatment by increasing insurance coverage.

The measure (AR-144), approved by a vote of 48-28-1, is part of the comprehensive Assembly Democratic anti-gun violence initiative, which is comprised of roughly two dozen bills.

“In order to ensure that people with mental illnesses have access to the treatment they need, mental health services must not be treated as the illegitimate step child of the health insurance world,” said Oliver (D-Essex/Passaic). “Mental health treatment is crucial to reducing suicide rates, violence and incarceration. This is a crucial component of any strategy to reduce gun violence. In the long run, the cost of providing mental health treatment is far less expensive than the socio-economic fall out of mental illness. It’s also the far more humane approach.”

The legislation urges Governor Christie to take a leadership role in the public mental health agenda and not apply for an annual exemption from the requirements of the federal Mental Health Parity and Addiction Equity Act of 2008.

“Despite the availability of effective mental health treatments, the rates for both adults and children that actually receive the help they need is alarmingly low,” said Wagner (D-Bergen/Passaic). “Without the proper treatment, certain mental illnesses can increase the likelihood of violence or suicide. Access to mental health treatment is crucial for any effective anti-gun violence initiative.”

The federal Mental Health Parity and Addiction Equity Act of 2008 requires group health plans and health insurance issuers to ensure that the financial requirements, such as co-pays and deductibles, and treatment limitations, such as visit limitations, applicable to mental health or substance abuse disorder benefits are no more restrictive than the predominant requirements or limitations applied to substantially all medical and surgical benefits.

Under current federal law, sponsors or administrators of self-funded nonfederal governmental group health plans may apply for plan exemptions from parity in the application of certain treatment limitations to mental health benefits under the Mental Health Parity and Addiction Equity Act of 2008.

The Executive Branch has been applying annually for an exemption from mental health parity since the 1980’s and 1990’s and from mental health and substance abuse parity since 2008 through plan design and the State Health Benefits Commission action, and in the current state fiscal year is exempt from mental health and substance abuse parity as it applies to visit limits which may reduce the efficacy of treatment.

The sponsors noted that approximately 50 percent of mental disorders begin before the age of 14; one in five of the world’s children and adolescents are estimated to have mental disorders or problems; and one in four adults experience a mental health disorder in a given year. However, the lawmakers underscored that fewer than one-third of adults and one-half of children with a diagnosable mental disorder receive mental health services in a given year despite the availability of effective treatments.

Approximately one in four state prisoners, one in five local jail prisoners, and seven out of ten youths in the juvenile justice system have a recent history of a mental health disorder, while over 50 percent of students age 14 and older with a mental disorder drop out of high school, the highest drop out rate of any disability group.

War and major disaster also have a large impact on mental health and psychosocial well-being such that rates of mental disorder tend to double after emergencies and lead to increased risk factors for communicable and non-communicable diseases, intentional and unintentional injury, and suicide.

Mental disorders are one of the most prominent and treatable causes of suicide. In the United States, the annual, indirect economic cost of mental illness is estimated to be $79 billion, most of which ($63 billion) reflects the loss of productivity, but the financial resources needed to treat mental disorders range between $2 to $4 per person, per year.

A duly authenticated, signed copy of the measure will now be transmitted to Governor Christie.