Mental Health Benefits Called at Risk

WASHINGTON — If insurance policies treated mental illness the same as physical illness, premiums would rise so high employers might quit offering any health benefits, the Congressional Budget Office said in a report released Tuesday.

The CBO findings are important because legislation is pending to require that mental and physical illnesses get equal coverage.

Budget analysts estimated that as many as 800,000 people might lose health insurance as a result.

Most employers already offer some mental health coverage, but with significantly less generous benefits than for other medical services, the budget office report said.

Requiring parity would cost employers an estimated $11.6 billion in 1998, “that we assume would ultimately be borne by workers,” the budget office said.

Based on the cost assumptions, the budget office said employers would likely:

* Raise the worker’s share of the premium.

* Cut wages and other fringe benefits.

* Reduce coverage for physical illness.

* Drop all health coverage.

Mental health advocates have lobbied long and hard to have diagnosable, treatable diseases such as schizophrenia or manic depression, considered the same for insurance purposes as chronic physical disorders such as heart disease or diabetes.

Their efforts paid off last month when the Senate included parity in its bill guaranteeing workers who lose or change jobs continue to get access to health insurance.

However, the provision is not in the House version of the bill, and Senate leaders have said it is too expensive to remain as negotiators start blending the House and Senate versions.

The budget office estimates that the provision would result in 400,000 fewer workers having employment-based health coverage. Considering workers’ spouses and children, the number could be as high as 800,000.

“But those estimates are highly uncertain because of the large margins of error in the study on which they are based,” congressional budget analysts said.