A.1171/S.6574-A – Requires Coverage of Outpatient Treatment for Mental Health Practitioners
Memorandum in Opposition
|For Immediate Release: May 24, 2021|
Re: A.1171-A (Bronson)/ S.6574-A (Kennedy) – AN ACT to amend the insurance law, in relation to health insurance coverage provided by a mental health practitioner and a clinical social worker; and to repeal certain provisions of such law relating thereto
The New York Health Plan Association (HPA) opposes A.1171-A/S.6574-A. This bill would expand the list of provided included under the mental health parity law to require health plans to cover services provided by any mental health practitioner, including mental health counselors, marriage and family therapists, creative arts therapists and psychoanalyst services. While HPA understands the desire to provide as broad an array of behavioral health services as possible, we believe the addition of these providers is unnecessary and will only lead to increases in the cost of coverage.
The current definition of licensed mental health professional is sufficiently broad, requiring that services be rendered by a “psychiatrist or psychologist licensed to practice in this state.” Expanding the definition to include any mental health practitioner could lead to the inclusion of services, such as dance and music therapy or educational screenings, that are beyond the scope of health insurance coverage.
Affordability and containing costs remain the top challenges in health care for employers and consumers. Mandating coverage of specific types of providers leads to higher costs and disproportionately affect small and medium-sized employers. Forcing employers to include benefits or types of providers they and their workforce may not want or need exacerbates the challenge they face to find affordable health care options. Bills mandating services provided by specific types of providers pertain only to fully-insured policies, which are generally those purchased either by individuals who buy coverage on their own or receive it through a small or medium-sized business. Large companies typically “self-insure,” providing employee health benefits by directly paying health care claims to providers, which are governed by the Federal Employee Retirement Income Security Act (ERISA) and therefore not subject to state mandated benefits. This exemption offers self-insured employers greater control over the particular benefits they cover for their employees.
One reason large employers typically self-insure is to avoid covering certain mandated benefits. Today, more than 50 percent of the commercial market in New York is covered under a self-insured plan. As more employers self-insure, state laws mandating specific types of benefits and services affect an increasingly smaller portion of the privately insured marketplace and fall largely on small and medium-sized employers.
At a time when New Yorkers are grappling with the high cost of health care, adopting new provider mandates exacerbates this challenge and does nothing to address underlying health care costs. For all these reasons, we urge you to reject A.1171-A/S.6574-A.
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