Federal and state laws require health plans and Medicaid managed care plans to guarantee equal coverage for mental health and substance use conditions as the coverage offered for physical health conditions. However, we continue to see people paying high out-of-pocket costs, having their claims denied, being placed on wait lists for months, or falling through the cracks in the mental health system. House Bill 1269 would change that.
The bill updates coverage language to align with modern medical practice so that when we talk about conditions involving people and their brains, statute can be responsive to evolving medical innovations.
Prevention and Screening
To improve Colorado’s mental health issue, we need to shift our mental health system away from responding only when a mental health or substance use disorder reaches a crisis. Instead, we should invest in prevention and early intervention. The bill will make it easier and more accessible for people to get screenings and mental wellness exams.
Transparency and Consumer Protection
Although state and federal parity laws have been enacted for over a decade, we still do not receive adequate data to show that insurance companies are following the law. This bill includes data reporting for insurance carriers and Medicaid to prove they comply with parity laws. It also helps to ensure that consumers understand their rights under parity and have tools to obtain adequate coverage for themselves or their loved one.
Closing Loopholes in Mental Health Care Coverage:
This bill stems from both national model parity language and stories of people being denied coverage because of gaps in the system. If we do not act, families with private insurance will continue to pay out-of-pocket for services that their monthly insurance premiums should already cover. For individuals enrolled in Medicaid, the state taxpayers will continue to pay more than once for a service that has a worse outcome.