Law would help pay insurance

by Amanda Derby

Tuesday, August 8, 2006 11:03 AM EDT

While we can't celebrate it as a law yet, Timothy's Law may just become that, after an agreement was reached in Albany between the Senate and Assembly in late June. Timothy's Law is a bill that would provide parity in insurance coverage for mental illnesses. This agreement is expected to be acted on officially once the Legislature reconvenes.
“After four and a half years, it is gratifying to see the Legislature coming together and recognizing the difficulties confronting families who need mental health insurance coverage. I look forward to the day when Timothy's Law is the law, and I urge this bill to be finalized as soon as possible,” said Thomas O'Clair, Timothy's father after the agreement was reached.

Timothy's Law was named after Timothy O'Clair, who hung himself in March of 2001 at the age of 12. His parents spent nearly five years trying to seek the necessary supports and services for his emotional disorder without success. The O'Clair's had health insurance through Thomas O'Clair's job with the New York State Thruway Authority. Their policy only allowed 20 outpatient visits per year for the psychiatrist and psychologist combined. Initially their physical health and mental health insurance co-payments were $10 per visit; however mental health visits became $35 each after just a few visits. As the family used up their coverage, they had to begin to pay for all appointments. Additionally, they found themselves having to pay for his extended hospitalization stays.

The Timothy's Law Campaign announced the agreement. “The agreement requires health insurance policies sold in New York state, not exempt under Federal law, to provide at least 30 inpatient days and 20 outpatient visits for mental health treatment. Perhaps more importantly, co-payments for accessing such services will be equalized with other co-payments for physical health needs included in a policy. This will bring to an end the exorbitant co-payments, often in excess of $50 per visit, commonly required to access mental health services. Affected insurance plans will have to cover conditions in a manner comparable to the insurance state employees and state legislators have access to under the Empire Plan. Small employers of 50 or fewer employees will be held harmless from any potential premium increases,” the Web site reported.

The agreement would also require insurance companies to fully cover treatment of biologically based mental illnesses including bipolar disorder, major depression, panic disorder, obsessive-compulsive disorder, anorexia, bulimia, schizophrenia/psychotic disorders, attentiondeficit/ hyperactivity disorders, disruptive behavioral disorders and pervasive developmental disorders. Small employers would have the option to purchase this same coverage.

It should be noted that when Assembly bill 2312-A went up for a vote in the Assembly this past March, 134 Assembly members voted for it, nine voted against it. Of our Assembly members, only Assemblyman Gary Finch voted in the affirmative. Both Assemblymen Brian Kolb and Bob Oaks voted against it.

This is only an agreement, so celebration for healthcare parity might be premature. We'll let you know once the Legislature reconvenes if this agreement becomes official and Timothy's Law is voted on and then signed by the governor.

Amanda Derby is the

housing advocate for

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