Below is a statement from Families Together in New York State on the historic signing into law of the State's first mental health parity bill entitled “Timothy's Law.“
The Best Holiday Gift Ever!
Moments ago, Governor Pataki signed Timothy’s Law (A. 12080/S. 8482). This is truly a time of gratitude on behalf of Families Together to the many organizations, families, providers, youth, advocates and concerned citizens who devoted their time and energy to this important issue. As Margaret Mead said, "Never doubt that a small group of thoughtful citizens can change the world. Indeed, it is the only thing that ever has."
This legislation will help millions of New York families access and pay for mental health care through their health care plans and HMOs. Families of children with special emotional and behavioral disorders can celebrate today. We know first-hand the trauma caused by the lack of services. Too many have endured crisis trips to the emergency room, have given up their homes to pay for treatment, have witnessed the slow starvation of anorexia, and suffered through suicide attempts of a son or daughter. Thanks to Timothy’s Law, our families now have hope for the future of their children.
About Timothy’s Law
Timothy’s Law creates a mental health benefit structure comprised of two mandates for large employers and a subsidized mandate paired with a "subscriber option" for the same coverage for groups with 50 or fewer employees.
All employers that offer health insurance and not exempt under federal law (self-insured plans) or state law (Healthy New York, Child Health Plus, Family Health Plus) will, for the first time, be required to provide broad based mental health coverage including at least 20 outpatient days and 30 inpatient days, with co-payments and deductibles comparable to those used for physical ailments (financial parity). Exclusions may be no more restrictive than the state's parity-based coverage for civil servants (and lawmakers), the Empire Plan. Exclusion of chronic mental illnesses would thereby be prohibited.
Importantly, the law requires the superintendent of insurance to "develop a methodology to fully cover the cost" of this “base benefit” mandate for employers with fifty or fewer employees. Not only does this provision address the concerns raised about the impact upon small employers (consistent with precedents that offer premium subsidies to farmers, doctors, people with AIDS, and small employers), but given the structure of this legislation, there is no evidence that any adverse impact is likely. Other states with even more comprehensive parity laws have not experienced the dynamic feared by some observers: That the mandate could cause employers to drop insurance coverage altogether. The statistic cited by these observers is not one involving mental health mandates, and it dates back to an era before managed care, dealing with the nation as a whole, and has no applicability in today’s insurance market.
In addition to this base benefit is a parity benefit. The parity benefit also includes "financial parity," and is required for all non-exempt employers with more than 50 employees. This same coverage is optional for small employers. It provides unlimited coverage of medically necessary care for children and adults with the following diagnoses: schizophrenia/psychotic disorders, major depression, bipolar disorder, delusional disorders, panic disorder, obsessive compulsive disorders, anorexia, and bulimia.
It also provides unlimited coverage for children under age 18 who have serious emotional disturbances and are diagnosed with attention deficit disorders, disruptive behavior disorders, or pervasive development disorders, where there are serious suicidal symptoms or other life-threatening self-destructive behaviors; significant psychotic symptoms (hallucinations, delusion, bizarre behaviors); behavior caused by emotional disturbances that place the child at risk of causing personal injury or significant property damage; or behavior caused by emotional disturbances that place the child at substantial risk of removal from the household.
Finally, the bill provides a "safety net" of sorts for all concerned by 1) requiring a two year study of the cost and effectiveness of mental health parity; and 2) allowing for the law to "sunset" on 12/31/09 unless it is reauthorized by the Legislature.