This morning, Gov. Ned Lamont was joined by a multitude of state officials, lawmakers and other stakeholders at a signing ceremony for SB 10, a bill that intends to significantly improve mental health coverage in the state.
“This is not just a bill,” said Dr. Javeed Sukhera, Chair of Psychiatry at the Institute of Living and Chief of the Department of Psychiatry at Hartford Hospital. “This is a chance for true accountability. It is the fulfillment of a promise, and it demands transparency, but more than anything, it is a declaration; to patients, families and to every mental health worker, including many in this room and across the state, that we see you, we hear you, and we are fighting for you.”
The ceremony was held at the Institute of Living in Hartford, one of the nation’s first mental health centers. Joining Lamont and Sukhera, was State Attorney General William Tong, Andrew Mais, the state’s Insurance Commissioner, Christian Damiana, Mental Health CT’s Public Policy Manager, Howard Sovonskry, the state’s Behavioral Health Advocate, Sean Scanlon, the state’s Comptroller, Adrienne Parham, a mental health advocate and social worker, and Senators Jorge Cabrera (D-Ansonia) and Matt Lesser (D-Middletown).
The bill includes a number of provisions to increase mental health parity, bridging the gap in insurance coverage that often exists between physical ailments and mental health disorders. The first three sections of the bill require insurers to file mental health parity compliance certificates to the state’s insurance commissioner, and allows the commissioner to impose fines on carriers who fail to to comply with state parity requirements.
“With this law, Connecticut now has one of the strongest parity enforcement frameworks in the country, real civil penalties, new transparency requirements and clear authority for the state to act when insurers don’t comply,” said Damiana. “It’s a powerful shift from hoping insurers do the right thing to holding them accountable when they don’t.”
Mais also stressed the bill’s lifting of anonymity requirements for insurance companies in violation of mental health parity compliance, saying it provides “additional accountability.” Lesser said that it will help employers or private citizens shopping for insurance to be informed of which insurers actually follow the law regarding coverage of mental health conditions.
“If you’re shopping around, whether you’re a business or your family and you’re trying to find the best coverage, you want to know whether or not your insurance company provides adequate mental health coverage,” said Lesser. “You can’t buy the right policy if you don’t know which one it is.”
The fourth and fifth sections of the bill cracks down on “step therapy”, a cost-reducing measure commonly used by insurers in which they initially agree to cover lower-cost and often less-effective prescription drugs, only agreeing to cover more expensive or effective drugs if the initially approved medications fail to treat a patient. The bill prohibits carriers from requiring the use of step therapy for drugs used to treat multiple sclerosis and rheumatoid arthritis, and makes permanent a prohibition on step therapy for drugs used to treat schizophrenia, major depressive disorder and bipolar disorder.
“That increases critical care to consumers,” said Mais.
The sixth and seventh sections work to lower health insurance costs, by allowing the commissioner to reduce insurers’ individual or small employer group health insurance rate requests by up to 2% if the insurer’s average approved rate increase exceeds the state’s health care cost growth benchmark. Mais described this as “a way that we can bend the cost curve, drive down the cost, and make the system more efficient.”
The eighth and ninth prohibits certain insurance policies from imposing time limits on anesthesia for medically necessary procedures. Lastly, the bill reinstates a provision repealed in 2023, that makes it an unfair trade practice to violate facility fee limits.
A few of the speakers shared personal experiences with the issue of mental health coverage in the state. One such speaker was Parham, who shared her long battle with an eating disorder and her difficulties with insurers. Parham said that inconsistent coverage for her various treatments has left her “with roughly over $20,000 of medical debt.”
“I recall staying in a hospital access room for intake of an eating disorder unit for over eight hours while waiting for a pre-authorization from the insurance company to prove that I was deserving of inpatient care,” said Parham. “I can also recall many instances of seeing other patients devastated when having to leave eating disorder treatment due to insurance coverage determining that they are not sick enough to receive treatment due to their weight or lack of physical evidence of illness.”
Parham said the bill would “take mental health treatment equity a step in the right direction.”
Lamont shared the increased volume of mental health concerns he saw during the onset of COVID, and said that “the stress that’s out there still, is severe as ever.” He recalled hearing from a student in Enfield High School during the peak of the pandemic that he would spend ARPA funding on mental health counseling. Lamont said that “the good news is, people are coming forward when they know they have this need, but it’s tough also seeing the incredible stress that is out there.”
“Physical health and mental health are one and the same,” said Lamont. “We’re going to make sure our insurance companies remember that every day.”
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