“Amanda Bacon’s eating disorder was growing worse. She had lost 60% of her body weight and was consuming only about 100 calories a day.
But that wasn’t sick enough for her Medicaid managed-care company to cover an inpatient treatment program. She was told in 2017 that unless she weighed 10 pounds less — which would have put her at 5-foot-7 and 90 pounds — or was admitted to a psychiatric unit, she wasn’t eligible for coverage.
“I remember thinking, ‘I’m going to die,’ ” the Las Cruces, N.M., resident recalls.
Eventually, Bacon, now 35, switched to a plan that paid for treatment, although she says it was still an arduous process getting the services approved.
Many patients, like Bacon, struggle to get insurance coverage for their mental health treatment, even though two federal laws were designed to bring parity between mental and physical health care coverage. Recent studies and a legal case suggest serious disparities remain.
The 2008 Mental Health Parity and Addiction Equity Act required large group health plans that provide benefits for mental health problems to put that coverage on an equal footing with physical illness. Two years later, the Affordable Care Act required small-group and individual health plans sold on the insurance marketplaces to cover mental health services, and do so at levels comparable with medical services. (In 2016, parity rules were also applied to Medicaid managed-care plans, which cover the majority of people in that federal-state health program for low-income residents.)
To read the full article click below: