Patrick J. Kennedy Calls for Congressional Hearings After Disturbing New Data Raises Huge Red Flags About Insurers’ Likely Violations of Federal Parity Act While Opioid Crisis Swept Nation


Washington, D.C., November 21, 2019 – As U.S. life expectancy declined over the past three years, primarily due to overdoses and suicides, new Milliman data shows insurers failed to adequately cover lifesaving care. With the release of this report, no insurance company can honestly say it is doing enough to tackle the biggest public health crisis of our time. More than 70,000 Americans died of overdoses in 2017, yet insurers spent a paltry 1% of their total health care reimbursement on substance use disorders—a decrease compared to two years earlier.

The new Milliman data from 2016 and 2017 also shows that insurers are by and large failing to address huge out-of-network utilization disparities between mental health/addiction and medical/surgical care for inpatient facilities, outpatient facilities, and office visits. This means people are paying more out-of-pocket for mental health/addiction care than they are for medical care—largely because insurers continue to reimburse mental health/addiction providers at significantly lower rates than their primary care/specialist counterparts, causing those providers to stop accepting insurance altogether. Consequently, people are depleting retirement accounts and taking out second mortgages to cover costs on their own. Frustrated families are often forced to give up and just hope for the best.

This report clearly shows that the insurance industry looked the other way as Americans were dying at record rates. It is time for insurers to double down on their own efforts to comply with the law. Insurance companies should be aggressively investing in innovative technologies and services to help providers extend their reach beyond the traditional care infrastructure, reimbursing mental health and addiction treatment providers on par with other providers, and being transparent in parity reporting.

But the reality is, everyone needs to step up if we are going to curb this crisis! The new Milliman data is not only an indictment of insurers, it is an indictment of our nation’s employers and regulators as well. Pharmaceutical companies can’t bear the burden of the opioid crisis alone—insurers and other stakeholders have roles to play.

Employers and regulators should be demanding proof of compliance with the Mental Health Parity and Addiction Equity Act, which requires insurers to cover treatment for mental health and substance use disorders no more restrictively than treatment for illnesses of the body, such as diabetes or cancer. Additionally, families and advocates must speak up and put pressure on the system to change instead of waiting for government and industry leaders to do the right thing.

To encourage action around the new Milliman data, The Kennedy Forum, along with Congressman Jim Ramstad and the heads of NAMI and Mental Health America, have submitted a letter to Chairman Frank Pallone of the House Energy and Commerce Committee and to Chairman Bobby Scott of the House Education and Labor Committee calling for congressional hearings on mental health parity. We urge the Committees to prioritize policy solutions, including these recommendations put forth by The Kennedy Forum, which will increase access to care and hold insurers accountable under the law.

Equality for those with mental health and substance use disorders is a matter of civil rights. The silence that pervades this space serves no one, as the data clearly shows.

###

About Patrick J. Kennedy:

Former Congressman Patrick J. Kennedy (D-R.I.) is a lifelong mental health advocate and former member of the President’s Commission on Combating Drug Addiction and the Opioid Crisis. He is the founder of The Kennedy Forum, a convening think tank tackling mental health and addiction issues and co-founder of One Mind, a global leader in open science collaboration for brain research. In 2015, he co-authored A Common Struggle, a New York Times best seller, which details his personal journey and provides a roadmap for the future of mental health policy. Mr. Kennedy is pushing for full enforcement of the Mental Health Parity and Addiction Equity Act of 2008. He was the lead sponsor of this groundbreaking legislation, which requires health plans cover mental health, eating disorder, and addiction care health benefits the same way they cover physical health benefits. To learn about Mr. Kennedy’s efforts, please visit www.patrickjkennedy.net.