2/4/2009 1:59:19 AM
HOFSTRA LABOR & EMPLOYMENT LAW JOURNAL
Public Perception of the Impact of Parity Laws
A study on the public perception of mental health throughout the U.S. divided the 50 states into three separate groups: strong mental health parity states, “medium” mental health parity states, and “weak” or “no” mental health parity states.69 Although this study was done before the passage of Timothy’s Law, post-Timothy’s Law New York would be best characterized as a “medium” parity state.70 The study found that states which recently enacted medium mental health parity laws did not have a much higher rate of utilization of mental specialty care than those states with weak or no mental health parity laws.71 Conversely, medium parity legislation was found to increase the use of mental health specialty services among those individuals who already had probable mental health disorders. 72
While acknowledging the limitations of their study, the researchers explained that their results displayed an inherent weakness in state parity legislation that is not present in comparable federal legislation.73 They surmised that there are four likely explanations for the statistical weaknesses of state mental health parity laws: (1) self-insured employers, who at one time encompassed an estimated 50% of all
74 i n insured workers, are exempted from these laws under ERISA; (2) s u r e d i n d i v i d u a l s m a y n o t b e k n o w a b o u t t h e i m p r o v e d c o v e r a g e ; 7 5 ( 3 ) managed care organizations may be increasing insurance “carve-outs, which separate nominal benefits from actual benefits” to mental health care;76 and (4) employers are not opposing parity legislation as vigorously in states where it is expected to have severe financial windfalls to “healthcare costs in the states of” the afore-mentioned
69. Yuhua Bao & Roland Sturm, The Effects of State Mental Health Parity Legislation on Perceived Quality of Insurance Coverage, Perceived Access to Care, and Use of Mental Health Specialty Care, 39 HEALTH SERVS. RES. 1361, 1365 (2004) (noting that for the purpose of the study, weak parity states are categorized with “no parity” states).
70. See id. at 1365. Bao and Sturm’s study explains that medium parity laws permit small employer and “if offered” exemptions—both of which are present in Timothy’s Law. Id. See also Timothy’s Law, N.Y. INS. LAW § 3221(l)(5)(D)(i) (McKinney 2006).
Bao & Sturm, supra note 69, at 1374.
Id. at 1373.
Id. at 1375 (“The findings suggest that state legislation is unlikely to be an effective
substitute for strong federal legislation, but limitations on the study preclude a conclusive answer.”). 74. Id. at 1374 (noting that this prevented the state legislation from extending to an adequate amount of people to have a remarkable impact at the “population level”).
Id. at 1375.
Id. (citations omitted).