When people seek mental health treatment in Washington, insurance companies should cover the care as if they were suffering from physical ailments.
Instead, people often know that coverage is denied – and they are not always told why.
A bill that passes through the state legislature is to change it.
For House Bill 1432, all the insurers in Washington State will need to follow the same set of the recommended and publicly available standards by doctors to meet mental health treatment.
The bill will also allow the Insurance Commissioner’s office to put additional pressure on insurance companies if they do not properly meet mental health, they need to increase the compensation rate for mental health services.
“Today, insurance companies are truly able to create their own rules for medical necessity,” said David Lloyd, a policy director of the national mental health, which helped draft this bill. “So this legislation will eventually create a combination of standards, a combination of rules for each patient, to ensure that they are receiving mental health coverage they are actually paying.”
Primary sponsorship of this bill, Reproductive Trae Siemens, said the bill would increase the need for Washington residents to access mental health treatment.
“We are still in a mental health crisis. This bill is about to solve real -life results that Washington residents have experienced when coverage is denied. “The more we take the job, the more circles we need to disconnect us from the potential care we need.”
There is still a decrease in coverage
Prior to the current state and federal laws, insurance companies need to cover mental health treatment, like physical health. This is a process called “mental health equality”.
Studies show that coverage of mental health treatment is often left behind.
An April 2024 Report from RTI InternationalA research unprofessional, showed that patients went out of the network for health care while they did 1/2 times 1/2 times for medical or surgical treatment – indicating that many of them could not find the veil through insurance. Patients to see psychologists also go out of the network more than 10 times, and nine times to see a psychologist than nine times.
Bill supporters say that equality is not being obtained, it is that insurance companies only need to cover therapeutic, which is considered “medically necessary” – a term that is not determined by the doctor’s recommendations despite the name. Instead, decisions about what is medically important are often based on the standards of private health organizations, which are then sold to insurance companies.
This system is often inconsistent between the approval of various insurance companies.
For example, some companies will cover high “care levels”, or the severity of treatment, which will leave others.
Brian Elunder, chief medical officer of King County’s Health and Recovery Division, noted in an email to the bill -backed lawmakers, noting that a major health organization that manufactures insurance guidelines, MCG Health does not stand with many national psychological organizations. For example, the MCG has not included some types of community-rive care programs in its standard, he said. Wrapped with deep servicesOr wise, who brings a team of professionals to help children with complex psychological needs to stay home.
“Commercial insurers are currently not contracting for this critical and evidence -based care level and are not covering them,” and as a result, it is a common reason that providers are encouraging adults who have been involved in their parents’ commercial plans for their parents. “
The bill will ensure that insurance companies have to follow another set of quality, which includes more types of mental health care in its coverage.
Since the bill makes its way through the House of Representatives, some lawmakers and health insurance companies have raised concerns that such changes can affect insurance operations as well as consumer costs.
Seattle -based health care company MCG, which sets standards for insurance companies and providers, emphasized some changes to the bill before proceeding.
Donna Baker Miller, Vice President of Government Affairs for MCG, said in an email that the company wants to allow insurance companies to continue using the standards of other organizations like MCG, unless it is more restrictions than the medical guidelines listed in the bill.
Until Thursday, lawmakers said change would be allowed as the bill proceeded.
Some people are also concerned that if insurance providers need to cover more services, this cost will reach consumers.
Jennifer Ziegler, a lobby of the Washington Healthcare Plans Association, told lawmakers that the bill would increase the insurance premium.
“Although the fund does not have a general effect on this bill, consumers have an effect,” said Zegiel.
But Lloyd, director of the non -profit policy, who helped prepare the bill, said it would help people overcome health care costs by getting the necessary treatment before increasing their problems.
“One of the things about mental health and the use of material is that when they are not treated effectively, people suffering from these situations often have the highest cost of health care,” he said.
Some people who spoke in support of the bill are also parallel between inaccessible mental health treatment and other widespread social issues.
“When people suffer from mental health or drug problem, they are often not a good lawyer for themselves,” said Jorjin Antizer, the Department of Psychology Department of Washington. “A person can have a good, employer health care. But if they suffer from the health or use of material, it is difficult to get timely, effective care. Things go to the edge and expose. You can lose this coverage, if you can access them, if we can access them, we can get better and more homeless.
