THE SENATE

S.C.R. NO.

116

TWENTY-SECOND LEGISLATURE, 2003

S.D. 1

STATE OF HAWAII

 
   


SENATE CONCURRENT

RESOLUTION

 

requesting an actuarial study on health insurance parity for the treatment of alcohol dependency and drug dependency.

 

WHEREAS, Act 202, Session Laws of Hawaii 1988 (Act 202), codified in chapter 431M, Hawaii Revised Statutes (Chapter 431M), mandated limited insurance coverage for the treatment of mental illness, alcohol dependency, and drug dependency; and

WHEREAS, Act 202 was originally set to be repealed on July 1, 1994, but subsequent amendments extended the repeal date to July 1, 2002; and

WHEREAS, Act 121, Session Laws of Hawaii 1999 (Act 121), established a distinction between "mental illness" and "serious mental illness", required insurance coverage for the latter to be no less than that provided for other covered medical and surgical conditions, exempted individual health plans, group health plans with twenty-five or fewer employees, and government employee health plans from the requirement, and was scheduled for repeal on July 1, 2005; and

WHEREAS, Act 243, Session Laws of Hawaii 2000 (Act 243), amended Act 121 by repealing the exemption for group health plans with twenty-five or fewer employees and government employee health plans, by establishing the general applicability of chapter 431M to these entities, and by moving up Act 121's repeal date to June 30, 2003; and

WHEREAS, Act 239, Session Laws of Hawaii 2002, made permanent the mandate for limited coverage of mental illness, alcohol dependency, and drug dependency by repealing Act 202's repeal date, but did not address the impending repeal of Act 121 which requires coverage parity for serious mental illness; and

WHEREAS, the Senate has approved and transmitted to the House of Representatives S.B. No. 1321 (2003), an Administration measure that proposes to make permanent the mandate for health insurance parity for the treatment of serious mental illness; and

WHEREAS, if S.B. No. 1321 is enacted into law, coverage for the treatment of serious mental illness under group and government employee health plans will be permanently on par with coverage for the treatment of other covered medical or surgical conditions; and

WHEREAS, the Legislature should consider requiring parity in coverage for the treatment of alcohol dependency and drug dependency; and

WHEREAS, full parity for substance abuse services is estimated to increase premiums by 0.2 per cent; and

WHEREAS, it is estimated that full insurance parity for substance abuse would increase premium rates for "typical" benefit plans from $0.14 per member per month for managed care plans to $1.35 per member per month for fee-for-service plans; and the composite increase premium rates is estimated at $0.66 per member per month, or less than $8 per year, which is an increase of 0.5 per cent in the total composite plan premium; and

WHEREAS, the Auditor's 1997 study, "Study of Proposed Mandated Additional Mental Health and Alcohol and Drug Abuse Insurance Benefits" (Rep. No. 97-19), cites low usage rates (two per cent for Hawaii Medical Service Association and four to five per cent for Kaiser in 1996) for mental health and substance abuse services; however, data did not differentiate between mental health and substance abuse utilization, or treatment utilization by children, adolescents, and adults; and

WHEREAS, prior to proposing such a requirement, the Legislature should consider the implications thereof, including the potential impact on health care costs; and

WHEREAS, if an analysis of substance abuse treatment benefits is to be useful, findings must address substance abuse treatment needs for those who may exceed the minimum levels addressed in section 431M-4(a), Hawaii Revised Statutes, such as the two episodes per lifetime limit on substance abuse treatment, and differentiate between the utilization by adults, children, and adolescents; and

WHEREAS, an actuarial study would assist the Legislature in its consideration of this issue; now, therefore,

BE IT RESOLVED by the Senate of the Twenty-Second Legislature of the State of Hawaii, Regular Session of 2003, the House of Representatives concurring, that the Insurance Commissioner is requested to conduct an actuarial study of a health insurance scheme that requires treatment for alcohol dependency and drug dependency, at rates and on terms and conditions no less favorable than those applicable to treatment for medical and surgical conditions currently required to be covered by health insurers; and

BE IT FURTHER RESOLVED that the Insurance Commissioner shall solicit, collect, and report data according to substance abuse treatment utilization by children, adolescents, and adults; and

BE IT FURTHER RESOLVED that the Insurance Commissioner shall conduct an analysis of those who have exhausted their substance abuse treatment benefits, including the two episodes per lifetime treatment limit for substance abuse; and

BE IT FURTHER RESOLVED that the Insurance Commissioner shall consult with the Department of Health, and with all interested parties, including the Board of Medical Examiners, the Board of Psychology, and representatives of insurance carriers, nonprofit mutual benefit associations, health maintenance organizations, public and private providers, consumers, employers and labor organizations, and State agencies which implement policies under Chapter 431M; and

BE IT FURTHER RESOLVED that the Insurance Commissioner shall submit to the Legislature a report of findings and recommendations, including any proposed legislation, no later than twenty days before the convening of the Regular Session of 2004; and

BE IT FURTHER RESOLVED that a certified copy of this Concurrent Resolution be transmitted to the Insurance Commissioner.

Report Title:

Alcohol and Drug Abuse Treatment; Actuarial Study