Therapy is health care. So why won't your health insurance pay for it?

[Jilly_in_VA]

At a time when it seems Americans don’t agree on much, we agree on this: The US is in the throes of a mental health crisis, one that predates the pandemic but which the pandemic made impossible to ignore.

Yet finding a mental health provider and, crucially, getting health insurance to cover their services continues to be a struggle.

Longstanding federal laws are supposed to ensure that health insurers cover mental health care just as they do physical treatments. But 15 years after Congress passed a policy that was supposed to achieve “parity” for mental health care, we still don’t have it. It seems to be much easier to get insurers to pay for a broken bone or high blood pressure medication than it is to get addiction treatment or find a therapist.

A recent survey of nearly 2,800 US patients found that 40 percent of patients who had sought in-network mental health care had to make four or more calls to find a provider who would see them — compared to just 14 percent for physical health care. More than half of patients said they had had a claim for mental health care denied three or more times, compared to about one-third who had the same experience with physical services

Now the Biden administration is taking new steps to hold health insurers accountable and, they hope, make it easier for Americans to get mental and behavioral health care.

But those are promises that have been made before. Experts sound cautiously optimistic about Biden’s proposal, but it’s too early to say if this time it’s different.

https://www.vox.com/2023/8/4/23815827/mental-health-therapy-services-health-insurance

[Jirel]

1. There are awful and good reasons for it, both.

Let's dispense with the awful ones - they all have to do with the continuing bias against mental health treatment, and mental health issues in general. They'll pay for repeated chemo or laser or dialysis, etc., but weekly or biweekly counseling? That's "just" talk (or EMDR, or whatever), so how, oh how, would they ever figure out if there's a measurable outcome? Well, newsflash, insurers, you can't get a measurable outcome on things like pain management, either, so really it's all just bias.

But, the one good reason is that there are so many quacks out there. That's something that has to be addressed separately, not by refusal to pay for therapy, though. In my rural area, there are very limited counseling options. The free county service really doesn't have therapy per se. Sure, it has "peer counseling" and "life skills counseling" (when they even have someone in the position, which turns over with the frequency of toilet paper, according to my clients) but that's not the same as an actual therapist that a person sees consistently for CBT or other specialized treatment. That leaves only one group in town that does sliding scale for what they *claim* is actual therapy. However, they're all quacks - they're christian-based garbage, and most of the people working there are short-time interns. Not one single client has ever had a good thing to say about them. Even the religious folks among them quit going there because they could recognize that spewing jesus-freak platitudes is not the same as actual therapy. The couple good therapists in town are, unfortunately, mostly tied up doing court-ordered work. That leaves several newbies who seem to be irregularly available as all get out, and one long-time nut-job therapist who stays fairly in demand because she doesn't disappear off the map when a wind blows. It's pretty sad. All of which would be solved if there was better oversight, and insurers were willing to pay. The good ones would hang around because they could actually earn a living helping people who need it, and the weirdos and zealots would no longer be the only game in town.

[flying_wahini]

2. It's just ridiculous that insurance companies doesn't consider mental therapy, or hearing aids or

Dental work part of your body’s necessary faculties. Outrageous that they continue to get away with it.