HCS HB 233 -- HEALTH INSURANCE

SPONSOR:  Holand

COMMITTEE ACTION:  Voted "do pass" by the Committee on Health
Care Policy by a vote of 13 to 1.

Under current law, there are several exceptions to the
requirement that health insurers who cover services for mental
illness and addictive disorders provide the same coverage as they
do for physical illness.  These include exceptions that allow
insurers to limit inpatient hospital treatment for mental illness
to 90 days per year (Section 376.811, RSMo), place annual and
lifetime limits on alcohol and drug abuse treatment services
(Section 376.827), and exclude or apply different limits to
certain specified services (Section 376.833).

This substitute repeals the current law and requires health
carriers that offer health benefit plans in this state on or
after January 1, 2004, to provide coverage for mental health
conditions.  Mental health conditions are defined as those listed
in the most recent edition of the Diagnostic and Statistical
Manual of Mental Disorders.  Coverage for mental health
conditions cannot have rates, terms, or conditions that place a
greater financial burden on an insured for mental health
treatment than for physical health treatment.

The substitute does not apply to supplemental insurance policies.

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund of
$3,129 to $6,258 in FY 2004, $6,445 to $12,890 in FY 2005, $6,638
to $13,276 in FY 2006.  Estimated Net Income to Insurance
Dedicated Fund of $8,000 in FY 2004, $0 in FY 2005, $0 in FY
2006.  Estimated Net Cost to Patrol Highway Fund of $29,130 to
$58,261 in FY 2004, $60,008 to $120,017 in FY 2005, and $61,808
to $123,617 in FY 2006.  Estimated Net Cost to Highway Fund of
$113,056 to $226,112 in FY 2004, $232,895 to $465,790 in FY 2005,
and $239,882 to $479,764 in FY 2006.  Estimated Net Cost on Other
Funds of $992 to $1,985 in FY 2004, $2,044 to $4,088 in FY 2005,
and $2,105 to $4,209 in FY 2006.

PROPONENTS:  Supporters say that mental illnesses are related to
physical illness experienced by patients; therefore, no
distinction should be made by health insurers between coverage
for mental health treatment and reimbursement of providers for
mental health services.  At least 30 states have mental health
parity laws.  Exemptions in the Missouri law for mental health
parity diminish that parity.  The bill does not mandate mental
health coverage but requires equity of coverage between mental
illnesses and physical illnesses.

Testifying for the bill were Representatives Holand, Riback
Wilson (25), and Moore; Burrell Behavioral Health of Springfield;
Timothy C. Harlan, President of the National Alliance for the
Mentally Ill, Columbia Chapter; St. Anthony's Medical Center of
St. Louis; Eastern Missouri Psychiatry Society; Missouri
Coalition of Community Mental Health Care Providers; Department
of Mental Health; Fulton State Hospital; Western Missouri
Psychiatric Society; Children's Mercy Hospital of Kansas City;
Missouri Statewide Parent Advisory Network; Susan Weinrich;
Missouri Recovery Network; Dan Bernskoetter; Crossroads of
Missouri; Edward Duff; National Association of Social Workers;
Missouri Association of Community Task Forces; Paraquad of St.
Louis; BJC Health Care Systems; United Healthcare; Missouri
Hospital Association; American Counselors Association of
Missouri; Missouri Association of Marriage and Family Therapists;
and American Federation of State, County, and Municipal
Employees.

OPPONENTS:  Those who oppose the bill say that the bill will
result in the shifting of additional health care costs to small
businesses and direct policy holders.  The bill contains a broad
definition for "mental health condition."  The bill does not have
cost containment provisions which are included in current law.

Testifying against the bill were Group Health Plan; Coventry
Health Plan; Missouri Chamber of Commerce; Blue Cross Blue Shield
of Missouri; Coventry Health Care of St. Louis; Missouri
Association of Health Plans; Associated Industries of Missouri;
and Golden Rule Insurance Company.

Joseph Deering, Legislative Analyst

Missouri House of Representatives
Last Updated July 25, 2003 at 10:11 am