Assembly Passes Mental Health, Addiction Coverage Bill

To Assembly member Jim Beall (D-San Jose), it just makes sense. When private insurers fail to cover addiction and mental health services, he said, the cost of those illnesses fall on the state.

“If you don’t treat it, it gets worse. If it gets worse, it gets shoved over to the public sector,” Beall said. “And then, if it gets shoved into the public sector, it gets worse. Then they end up in prison, with a substance abuse or mental health problem in prison, and this is costing the state way too much money. We need to stop the cycle.”

Beall is the author of AB 154, a bill requiring insurers to cover mental health and addiction services, which passed the Assembly floor late last week.

It’s a bill, Beall said, that won’t cost the state a dime.

But it will still end up costing Californians, according to Dan Logue (R-Linda), in the form of higher premiums that could rise ever higher as legislators require more and more coverage from insurers.

“This mandate’s going to cost Californians,” Logue said. “We’re jumping before we look over this cliff, and we may find there’s no water there.” The recent legislative mandates for coverage all add up to substantial cost, he said. “We look at health care as a candy store,” Logue said, “and we want one of everything.”

Chris Norby (R-Fullerton) said he has a hard time mandating something as subjective as mental health conditions. “Physical disease is much more identifiable,” Norby said. “How do we define mental illness? There are 283 different mental and substance abuse issues here. Before we open the floodgates to these mandates, what will be defined as mental illness?”

Assembly member Richard Pan (D-Sacramento), who is a pediatrician, said health providers actually have a clear definition of substance abuse and mental illness. “Physicians spend a lot of time debating that very thing,” Pan said, “and the diagnosis is carefully arrived at. It’s thought out, by health professionals.”

Assembly member Charles Calderon (D-Whittier) had a different take. He said that now is the time to clarify coverage needs because the health care landscape is about to change with the creation of the Health Benefit Exchange, scheduled to start up in 2014.

“For too long, mental illness has been the ugly stepchild of what can be covered, and what shouldn’t be covered,” Calderon said. “We are now about to go into negotiations with insurers, and substance abuse and depression should be in that conversation. We need to get it done now.”

The Assembly voted 47-18 on Friday to pass AB 154. The vote later was amended to 49-22.

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