Testimony by Thomas J Kim, MD, MPH
House Public Health Committee House Bill 10
February 28, 2017
Good day, Chairman Price and members of the committee. My name is Dr. Thomas Kim. I’m an internist and psychiatrist here in Austin who practices telehealth care. Today I’m testifying on behalf of myself and the 50,000 physicians and medical students of the Texas Medical Association (TMA), Texas Pediatric Society (TPS), and Federation of Texas Psychiatry (FTP).
Together we would like to thank Rep. Four Price and Sen. Judith Zaffirini for House Bill 10 and Senate Bill 860 seeking to further codify mental health parity in Texas. We further wish to broadly thank the 85th Texas Legislature for its clear commitment to meaningfully addressing the many challenges we face with mental health care delivery.
Mental health parity in its simplest terms seeks to manage mental illness as we would any physical illness. For reasons too numerous to mention, mental health services historically have been limited or capped in some way, preventing the appropriate management of mood, behavior, or addiction issues. Yet it stands to reason that just as we would not limit the number of encounters to manage someone’s blood sugar or require recurring preauthorizations to control high blood pressure … mental health parity essentially considers mental illness like any other chronic illness.
This consideration legislatively began in 1996 with the Mental Health Parity Act, which equated any limits on mental health benefits with those found in medical and surgical benefits. This act, however, excluded substance abuse and dependence coverage and lacked specific guidance on how to restructure mental health benefits. In 2008, the Mental Health Parity and Addiction Equity Act included addiction benefits and an attempt to formalize a path towards maintaining mental wellness, but only for insurers that chose to offer such benefits, larger employers, Medicaid, and Children’s Health Insurance Program managed plans. More recently, the definition of small employer has undergone some modifications, which of course impacts the expectation for parity. This brief review of legislative efforts reveals positive, incremental progress in what I believe to be the purpose of government: supporting the prosperity of its citizens … no more, no less.
House Bill 10 builds on this progress in three ways:
- The designation of an ombudsman advocacy resource,
- The establishment of a Texas Health and Human Services Commission Mental Health Parity Work Group, and
- Definitional guidance with mental health and substance use benefit terms and coverage.
This bill will hopefully yield:
- Improved Texas Department of Insurance empowerment of mental health parity oversight,
- Increased physician and patient engagement towards realizing true parity, and
- Identification of areas of concern where we can improve historic parity challenges.
The TMA, TPS, and FTP fully support House Bill 10.
A final, more personal comment is to highlight the uncertainty in the road ahead. With just a glimpse into the proposed federal budget priorities and intentions with respect to health care funding, I think that we can all agree that interesting times are in store. And through my work as a psychiatrist, I know that uncertainty sometimes can cloud both our intentions and our actions. The importance of mental well-being cannot be overstated. Challenges to our mental health negatively affect physical well-being, productivity, and overall quality of life. We must shift our mental health care system away from the reactive response of providing the most expensive forms of care to people at their lowest to a proactive response of cost-effectively maintaining mental well-being by supporting people at their best.
I look forward to seeing how HB 10 and SB 860 will assist us in that goal. Thank you.
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