Health Association in New York State, Inc.
Friday Fax from Albany
Final Push for Timothy’s Law: With the Legislative Session ending in less than one week, we are asking everyone to contact everyone you know and urge them to advocate for Timothy’s Law.
We are asking that everyone call their Senator with the message, “Please Urge the Leadership to Pass Timothy’s Law.”
Even more importantly, please call Senate Majority Leader Bruno, urging him to "Pass Timothy’s Law."
Senate Switchboard - 518-455-2800
more information contact Timothy’s Law Campaign (TLC)
To find out who your Senator is, check http://map01.elections.state.ny.us/boe/main.asp
NEW YORK STATE SENATORS LISTED BY COUNTY
Timothy’s Law in the News:
Let Insurers Scrimp on Care for Mental Illness
Timothy's Law could just as easily be called Tom's or Donna's - for the parents of the 13-year-old mentally ill boy who hanged himself in his bedroom closet, and whose medical insurance hadn't paid for the care he needed.
It's Tom and Donna O'Clair who have crusaded tirelessly to require medical insurers in New York and other states to cover the cost of mental illnesses as extensively as others. And it's their lobbying that has brought passage of a mental-health "parity" bill much closer to a reality.
Last week, the Assembly again overwhelmingly approved a measure that would bar insurers from imposing caps or copayments on treatment for mental illnesses or drug or alcohol addiction that don't also apply to other illnesses. The Democrat-controlled Assembly has done so for the past three years, but the Republican Senate has refused to consider the change, citing concerns of insurers and businesses that it might increase premiums.
Evidence suggests that premiums would rise only by small amounts, while people who seek help for mental disorders face unmanageable costs.
As a result of mounting public support, however, Senate leaders now seem prepared to let lawmakers vote on a bill. They ought to resolve any differences with the Assembly and approve a measure before the legislative session ends, for Gov. George Pataki's signature.
Now, insurers limit treatment for depression, substance abuse or other psychological disorders by capping the number of treatment sessions or the annual cost, although they don't do the same for cancer, heart disease or other maladies. That's what hurt the O'Clairs, whose health insurer stopped covering Timothy's increasingly expensive treatments.
Eventually, the O'Clairs were forced to place their child in foster care, in an effort to get him publicly funded treatment under Medicaid. Nobody should have to go through such heart-wrenching contortions. Dealing with mental illness is tough enough.
health bill sparks debate. By Jay Gallagher
(June 7, 2003) — ALBANY — On March 16, 2001, Donna O’Clair of Schenectady went food shopping with one of her sons.
When they returned home, she found that her youngest, 12-year-old Timothy, had hanged himself in the closet in his bedroom.
Largely because of that incident, state lawmakers are considering approving a sweeping expansion of mental health services that health insurance policies have to cover. The bill has already passed the Assembly and Senate action could come as early as next week.
To its supporters, the passage of the bill would end what they see as discrimination against those with mental illness. Treatment of emotional and behavior disorders, as well as drug addiction and alcoholism, would be covered to the same extent as physical problems such as heart attacks and cancer.
But to its detractors, passage of the measure would mean fewer New Yorkers would be able to afford health insurance and thousands would be added to the rolls of the state’s uninsured. That’s because the mandate would drive up premiums.
“We’re basically looking at stamping out discrimination and injustice against those who are mentally ill,” said Assemblyman Paul Tonko, D-Amsterdam, Montgomery County, sponsor of the Assembly bill.
“People with mental illness are as sick as individuals with prostate cancer or breast cancer. Why should they be left out?” asked Senate sponsor Thomas Libous, R-Binghamton, Broome County.
But opponents worry about the cost.
“I was told when I came to Albany that we’re all against unfunded mandates, until we see one,” said freshman Assemblyman Daniel Hooker, R-Sharon Springs, Schoharie County. He was referring to the often-criticized practice of state government to require local governments, businesses and other groups to incur costs without providing the money to pay for them.
“There’s simply not enough money in government coffers or in the checkbooks of businesses to pay for every nice idea we have,” he said.
Timothy O’Clair has become the focus of the debate because he exhausted all of the mental health care his family’s policy had: 30 days of in-patient care and 20 outpatient visits.
But his problems didn’t end when his benefits ran out. His father, Tom, said that sometimes Timothy would kick his mother in the shins, attack his siblings or try to hurt himself.
His parents, who have traveled around the state for months to build support for the bill, eventually turned over custody of their troubled son to Schenectady County. That way he qualified for Medicaid, the taxpayer-financed health insurance program. That allowed him to be sent to a residential treatment center for seven months, on the taxpayer tab, before being allowed to return home. But six weeks after his return home, he committed suicide.
The measure breezed through the Democrat-led Assembly, but it faces a stiffer test in the Republican-run Senate.
While Libous is solidly behind the bill, Senate Majority Leader Joseph Bruno, R-Brunswick, Rensselaer County, hasn’t said whether he supports it.
“A lot of people have expressed support for this legislation,” said Bruno spokesman Mark Hansen. But “there have been concerns raised about the potential financial impact of the bill.” He said the Senate hoped some form of the bill could be enacted before lawmakers leave town. That’s supposed to happen some time before the end of the month.
Gov. George Pataki, who would have to sign the bill for it to become law, hasn’t said whether he supports it.
Opponents and supporters of the bill have widely varying estimates of how much so-called “mental health parity” would cost.
Supporters put it at about $1.26 per month per health insurance subscriber, or about 1 percent, while opponents say it could be as high as $7.56 per month, or about 3 percent. Both cite the experience of other states and studies to buttress their positions.
The higher cost would be tacked on at a time when businesses are already struggling with sharply higher costs for health insurance, business spokesmen said.
“At a time when rising health care costs are already driving double-digit premium increases, scrutinizing the cost impact of proposed mandates no matter how well intentioned is particularly critical,” said Mark Amodeo of the state Conference of Blue Cross and Blue Shield plans.
“We think it’s bad public policy to require richer insurance benefits for a diminishing few,” said state Business Council spokesman Matthew Maguire.
The council figures based on surveys of that for every 1 percent premiums go up, 30,000 people will lose coverage, since either they or their employers will decide they can’t afford to offer health insurance. That would add to the more than 3 million New Yorkers now lacking coverage.
The state already has over 30 mandated benefits that add $1,000 a year to the health insurance costs of the average family, according to a study cited by the Business Council.
By Laura Githins Hatch
(June 7, 2003) — Thousands of mentally ill New Yorkers, both children and adults, are going without adequate treatment because they lack insurance comparable to coverage provided for physical ailments, injuries or diseases. Of course, this kind of blatant discrimination needs to end.
The problem, however, is that requiring insurers to offer fully expanded mental health benefits now would almost certainly exacerbate mounting financial hardships of most New Yorkers and businesses. Too, the ranks of the uninsured would likely increase.
But this scenario doesn’t mean the Legislature should do nothing. It should begin now to look at ways of rolling out expanded mental health coverage over a period of years and also identify ways to help pay for it.
Too, state lawmakers should commission an independent study to project the additional costs to businesses and consumers. Yes, there are ample studies already available. But most of them were conducted by organizations with a vested interest in the results.
For example, while premium increase projections of 3 percent to 5 percent by the state Conference of BlueCross and BlueShield plans might be accurate, it can’t be overlooked that the insurers vigorously oppose mandated mental health benefits. Similarly, projections from pro-expanded benefits groups must also be scrutinized.
This much is certain: There will be added expense from full mental health coverage. Not only would businesses and state residents, already reeling from local and state taxes, face yet another expense, but it’s likely that health care costs overall would increase. Consequently, fewer companies would be able to afford the costs, thus increasing the ranks of uninsured New Yorkers.
The Legislature should start out requiring expanded benefits for children or patients with certain diagnoses in hopes that coverage could be extended as the economy improves.
Meanwhile, the state should cushion the blow of the extra expense to consumers and businesses by identifying taxpayer savings in New York’s mammoth Medicaid program, for instance. By reducing the cost of the health care program for the disabled and poor, which county governments help fund, local property taxes could be kept stable or trimmed.
Correct the unfairness of limited coverage for mental health and drug abuse patients. But do it the smart way.
next time, we remain,