Mental health parity laws don’t work. Santa Clara County wants to act

Despite several federal and state laws passed in recent decades to ensure that health insurance companies cover physical and mental health equally, many still do not get the mental health treatment they need. Now, Santa Clara County wants to join the fight for mental health parity.

As recently as 2020, state lawmakers attempted to strengthen California’s mental health parity law, which was first passed in 1999. The most recent version, led by Sen. Scott Wiener (D-San Francisco), expanded the types of medically necessary treatment and mental health care. illnesses – including substance use problems – that health insurance companies should cover. The previous law only covered treatment for nine serious mental illnesses.

Despite these bold promises, patients continue to fall through the cracks, as noted by mental health advocates who, in a May letter to the state Department of Managed Health Care, questioned whether the agency was enforcing the new law.

“This is a health issue, pure and simple,” said Santa Clara County Supervisor Joe Simitian. “If someone shows up with a broken arm, their insurance covers it. If someone presents with a need for mental health care, there should be no doubt that they will get the help they need. Unfortunately, this is not the case today. It is high time to take this seriously.

Earlier this month, Simitian and his Supervisor Cindy Chavez filed a referral asking the county to address the problem – whether by sponsoring state legislation or filing a lawsuit to keep companies from responsible insurance. The county has already gone to court over public health issues, suing paint manufacturers against lead paint companies and pharmaceutical companies for fueling the opioid crisis, both of which resulted in hefty settlements in favor of the county.

Simitian said that while litigation shouldn’t be the first choice, the county “shouldn’t shy away from it.”

“We must be willing to roll up our sleeves and, if necessary, wade into the legal system to ensure that insurers here in Santa Clara County and in California are doing at a minimum what the law requires,” Simitian said .

The county council office is expected to report on the issue to the Health and Hospital Committee in mid-December and to the full Board of Supervisors in January.

Rebecca Basson, an attorney at the Law Foundation of Silicon Valley, said one of the biggest problems with mental health parity laws is that while they guarantee patients coverage for mental health treatment on a par with physical health treatments, they do not necessarily guarantee quality. treatment or be able to find a provider.

Earlier this month, Kaiser Permanente agreed to a $200 million settlement with the state over patients facing significant delays in receiving behavioral health treatment. They will pay a $50 million fine and promised to address “deficiencies in plan implementation and behavioral health oversight,” according to a press release from the California Department of Managed Care. The remaining $150 million is a commitment from Kaiser to improve behavioral health services over the next five years.

At the Law Foundation, Basson said the inability of many of their clients to access quality outpatient care has led them to require hospitalization.