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Ill. lawmakers pass eating disorder coverage bill

Posted Sep 24 2008 12:12pm

I bring you good tidings from the state of Illinois, where House Bill 1432 has been passed by the Illinois House of Representatives!

I reported on this bill in June while it was “under review” by Ill. Governor Rod Blagojevich and encouraged readers to contact the governor encouraging him to sign it into law. Only 16 states mandate insurance companies to pay for the treatment of anorexia and bulimia. The passage of HB 1432 makes Illinois the 17th such state. The bill changes the state’s definition of “serious mental illness” to include anorexia, bulimia, and ED-NOS. These disorders are already recognized as such by the most current edition of the Diagnostic and Statistical Manual, so HB 1432, in essence, brings Illinois up to date with current medical standards. The bill also requires coverage for 45 days as an inpatient and 60 outpatient visits each calendar year. While still not enough coverage for severe cases, it ensures at least a modicum of treatment coverage for thousands of Illinois residents struggling with an eating disorder.

Blagojevich amendatorily vetoed the bill on Aug. 29, but don’t shoot off scathing emails just yet. An amendatory veto means that a governor can veto any piece of legislation with recommendations for change and then send it back to be approved by the legislature. It doesn’t appear as if Blagojevich held any opposition to the eating disorder legislation, but rather wanted to expand other other parts of the bill unrelated to eating disorders. His recommendations would have required insurance companies to also cover treatment and services for victims of sexual assault, and would have capped the financial responsibility of these victims and their families (including same-sex partners!) for these services at 40 percent. Once the house amended the bill to reflect these recommendations, the governor promised his full support for the bill.

The house overrode the governor’s amendatory veto on Sept. 10 and summarily passed the bill as-is with 77 yays and 36 nays. House Bill 1432 is now law in Illinois, although I am not sure when it actually goes into effect.

Gov. Blagojevich appears to be a strong ally in the growing movement for mental health parity and a proponent for improved citizen health overall. He announced a new program this month that promises to improve treatment for children with mental health and substance abuse problems. He also recently signed into law House Bill 5285, which allows parents to extend health insurance coverage of dependents until their 26th birthday, and up to age 30 for veterans. And he opposed recent proposed federal rules which would allow healthcare providers to refuse federally funded medical services treatment on the basis of personal beliefs.

Laws like HB 1432 are crucial because without government oversight, insurance companies can make decisions based not on what are in the best health interests of subscribers, but rather what’s fiscally best for the company. All too often, insurance companies use this decision-making power to deny coverage for disorders that overwhelmingly affect women. Despite research that confirms anorexia to be a brain disorder curable with appropriate mental and physical treatments, insurance company continue to argue that there are no standards prescribed for the treatment of eating disorders. They claimed that this lack of medical protocol gives them – not doctors — the ultimate authority to determine whether or not a recommended treatment is medically prudent. Insurance companies consider an eating disorder more “severe” and ergo, more justifiable for treatment, by the number of times it recurs. Yet medical research shows that it is often the absence of early treatment that frequently leads to relapse and that patients whose disorders are treated in the early stages have drastically improved recovery rates.

I applaud Blagojevich and those 77 Illinois state legislators who supported HB1432. Not only does this bill promise help and hope for Illinois residents with eating disorders, it also makes a strong national statement in support of mental health parity that may potentially spark similar legislation in other states. But we shouldn’t have to rely on state legislators to pass such bills – such responsibility ought to lie with Congress, who, with one fell approval, can require equitable coverage on a national scale. Congress had a prime opportunity to do just that in 2005, yet the GOP-dominated 109th Congress failed to pass the Mental Health Equitable Treatment Act, which would have required insurance companies to treat mental and physical illnesses the same.

Eating disorders are treatable mental illnesses, but left untreated, can be as deadly as cancer. HB 1432 represents a significant victory, but sadly its one enjoyed by only a small percentage of people with eating disorders. I encourage you to contact your own state’s congressional representatives and urge them to support and promote mental health parity legislation.

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