Iowa House Report

In the last few years, a lot of legislative activity has taken place regarding coverage for mental illness. This movement has generally been referred to as mental health parity. Proponents of mental health parity typically want mandated mental health and substance abuse insurance coverage and argue that to do otherwise would be discriminatory.

Opponents argue that mandating mental health insurance coverage would result in an astronomical increase in insurance premiums. While the majority of state legislatures have taken some action on mental health parity, they have varied widely in terms of the level of "parity" provided. The Iowa Legislature recognizes the need to provide mental health insurance, but understands the potential economic impact of mandating full mental health coverage.

House File 420, which was passed by the House February 28, addresses the parity issue by balancing the need to provide coverage for the treatment of mental illnesses while keeping premium increases to a minimum. House File 420 strikes this balance in the following manner: it requires that group health insurance policies provide coverage benefits for the treatment of biologically based mental illness if the policy or contract is issued to: 1) an employer with 50 or more full-time employees, or 2) an employer, with between 2-50 full-time employees, that already offers mental health benefits. The bill does not affect persons on Medicare, Medicaid, federal benefit programs, the individual insurance market, or employers who self-insure.

Importantly, the bill defines "Biologically based mental illness" as to include the following conditions:

* - Schizophrenia;

* - Bipolar disorders;

* - Major depressive disorders;

* - Obsessive-compulsive disorders;

* - Schizo-affective disorders;

* - Pervasive developmental disorders; and

* - Autistic disorders.

The bill requires any group policy covered under this law to allow at least 30 inpatient visits and 52 outpatient visits annually. The policy may also include deductibles, co-pay and coinsurance, but only if the deductibles, co-pay, and coinsurance also apply to other medical or surgical services coverage.

Consistent with our intention to minimize any increase in insurance premiums, certain services may be excluded from coverage under the bill. They include:

* - Marital, family, educational, developmental, or training services;

* - Care that is custodial in nature;

* - Services or supplies that are not medically necessary or clinically appropriate; and

* - Experimental treatments.

We believe the bill provides coverage for a vulnerable population while maintaining affordable health insurance premiums for all Iowans.

Next Week in the House

The following Bills will be eligible for debate as of Monday, March 7:

HF 85 - A bill for an act eliminating the certified mail requirement concerning the service and delivery of certain civil rights complaints and orders;

HF 162 - A bill for an act relating to an appropriation from the environment first fund for the establishment of permanent soil and water conservation practices, by allocating moneys to support the administration of local governmental units, and providing and effective date;

HF 398 - A bill for an act adding an exemption for colleges and universities established by city ordinance to the requirements relating to the registration of postsecondary schools;

HF 399 - A bill for an act relating to the disposal of solid waste by planning areas and related solid waste management plans and reports;

HF 418 - A bill for an act concerning billing for anatomic pathology services and making licensing sanctions applicable;

HF 423 - A bill for an act relating to participation in secondary school interscholastic sports at the varsity and inferior levels;

HF 440 - A bill for an act relating to sanctioning the motor vehicle operating privileges of a person upon a second or subsequent conviction for motor fuel theft from a retail dealer;

HF 469 - A bill for an act increasing the membership of the real estate commission;

HF 506 - A bill for an act relating to tax credit certificates issued by the Iowa capital investment board and providing an effective date.

As always, please feel free to contact me with any questions or concerns that you have. I can be reached at chuck.gipp@legis.state.ia.us or by phone at 515-281-3054.