Most Illinois insurance companies will be required to provide mental and substance abuse services to their beneficiaries beginning Jan. 1 under a new bill Gov. J.B. Pritzker signed into law.
Senate Bill 471 requires insurance providers to ensure an adequate network of mental healthcare providers is available for beneficiaries that must be within 30 miles or 30 minutes driving distance. If not, insurers must pay for a provider outside the network.
Chair of Public Policy for Mental Health of America Illinois Mark Heyrman says this bill is aimed at fixing a decades-old problem.
“Health insurance companies typically do not provide the same level of coverage or provision of care for mental health conditions that they do for other health conditions,” Heyrman told The Center Square.
The bill attempts to fix a problem called network adequacy, Heyrman said.
“You can say you’re covering mental health services, but if you don’t have providers who are available to persons who need mental health services, that doesn’t mean much,” he said.
Not only will this help folks in need, but it will also benefit the economy, according to Heyrman, because most people with mental health problems hold jobs.
“If they have a mental health problem and they can’t get treatment for it because it’s not covered by their insurance, then they deteriorate and lose their job,” Heyrman said. “Then what happens is we as taxpayers must pay for them because then they’re eligible for Medicaid.”
Heyrman said this will be good not only for patients but for providers as well. One of the reasons many mental health provider networks are underpopulated is because insurers don’t pay enough to attract them, he points out.
“It will force insurance companies to pay enough — to reimburse enough — to make sure they get enough providers in their network,” Heyrman said.
Despite requiring insurers to pay more, insurance premiums shouldn’t go up, Heyrman said. If mental health problems are addressed, patients will take better care of themselves, he said.
No one testified against the bill during the legislative process.
“Suppose you have a mental health condition and you have diabetes or hypertension or other things,” Heyrman said. “If you’re depressed, you may be too depressed to go get help for those other things and they get worse and the insurance company is forced to pay for it.”
August 11, 2021 at 06:58AM