New York, Ohio adopt limited mental health parity coverage

They join a majority of states requiring insurers to provide mental health benefits that are more on par with coverage for physical illnesses.

By Doug Trapp, AMNews staff. Jan. 22, 2007.

Washington -- Years of lobbying finally paid off for physician groups and consumer advocates in Ohio and New York with new laws mandating improved insurance coverage for mental illness.

In late December 2006, the outgoing governors of each state signed measures into law aligning the two states with 36 others that have adopted at least limited mental health parity laws.

Neither law covers substance abuse treatment, contrary to policy supported by the American Medical Association. The measures apply to insurance plans offered only locally in each state and not plans that cross state borders.

Still, Timothy's Law is the most significant piece of mental health care access legislation in the state's history, said C. Deborah Cross, MD, president of the New York State Psychiatric Assn.

The measure is named after Timothy O'Clair, a 12-year-old from Schenectady County who committed suicide. He was unable to get treatment for his emotional disorder under his parent's insurance. His father, Tom O'Clair, campaigned for the law for years by holding candlelight vigils and other events. The New York law was a success in large part because of the emotional appeal of this real-life example, Dr. Cross said.

"This is not a perfect bill. However, it is a start," Dr. Cross said. She added that full parity with physical health benefits is the goal.

New York's law is the stronger of the two. It will reimburse small businesses -- those with fewer than 50 employees -- for the cost of providing standard coverage of 20 outpatient visits and 30 inpatient days for mental illness in a calendar year. One early estimate put that cost at $20 million to $30 million for the state, said Seth Stein, executive director and general counsel for the New York State Psychiatric Assn.