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APA’s Board of Trustees is calling on the American Medical Association to put its money where its mouth is on the critical issue of incorporating mental illness parity in health insurance policies.
While the AMA supports APA’s commitment to working for the enactment of laws mandating that insurers provide equal coverage for mental and physical illnesses, the insurance policies the AMA offers its members contain discriminatory coverage limits and copayment requirements when psychiatric disorders—including substance abuse disorders—are the ones being treated.
The Board’s discussion of this issue at its September meeting revealed little opposition to instructing APA’s delegates to the AMA to inform that organization’s board "in the strongest terms possible" of APA’s interest in seeing the AMA alter the terms of its health insurance policies to offer nondiscriminatory coverage.
The proposal originated with the APA Assembly, which passed it during its May meeting in San Diego.
One insurance policy the AMA offers and markets as "a cost-saving alternative" is called the Comprehensive Medical Expense Insurance Plan. It provides for up to $2 million in lifetime coverage for all illnesses, but excludes mental and substance abuse disorders from that lifetime limit. For mental illnesses, coverage is limited to $25,000 during any two-year period, while a $50,000 cap is imposed on substance abuse treatment for each two-year period.
Area 4 Trustee Norman Clemens, M.D., called on APA’s delegates to the AMA to "push this issue aggressively." This suggestion was echoed by immediate past president Harold Eist, M.D., who urged his colleagues to empower psychiatry’s AMA delegates to prepare a resolution to be introduced in the House of Delegates, the AMA’s main policymaking body.
Also strongly urging Board members to take a stand with the AMA was Area 7 Trustee Michael Myers, M.D. Myers emphasized that the parity issue is especially crucial for younger physicians, "who are often seduced into insurance plans that appear to be comprehensive on the surface, but in fact are not," and come with premiums that may be more affordable. "They don’t yet appreciate how serious the health consequences of catastrophic stressors can be," he said, and as a result pay too little heed to the importance of having an insurance policy that provides comprehensive coverage of mental illness treatment.
Jay Cutler, director of APA’s Division of Government Relations, pointed out that APA officials have already held discussions with the AMA about the insurance coverage issue. The AMA representatives, he said, conveyed their intention to remedy the discriminatory provisions regarding mental illness treatment but do not plan to do so for substance abuse services, which are not included in the Domenici-Wellstone parity law.