Monday, June 13, 2005
S enate Bill 1, providing health insurance parity for mentally ill Oregonians, is caught in the deal-making of the last days of the Legislative Assembly. If this sausage-making is hard for the public to stomach, imagine how it looks to the exhausted families that have spent themselves into bankruptcy trying to get care for their mentally ill children.
If House Republicans get Senate Democrats to swap a capital gains tax cut for parity, Kathleen Ris could get to keep her son, rather than endure again the pain and humiliation of signing over his custody to the state, just to get him the health care that he needs.
Or, if House Speaker Karen Minnis gets the Senate to trade parity for her school funding plan, Sonja Tanner could get help the next time her son's mental illness flares, and he grabs a knife and vows to kill a boy having a birthday party across the street.
"It is nauseating," says Ris. "It just makes me sick. They think my son's health and his life are so trivial that this is just another bill to swap."
Senate Bill 1 would prohibit insurers from discriminating against people suffering from diseases of the brain. It is not just another bill; it is a long-overdue recognition of mental illness as a condition, not a stigma. It is a declaration that Oregon families should not have to lose everything, even custody of their children, to the hell of a mental illness.
Thirty-five other states already have some form of a law preventing insurers from putting more restrictions, such as spending caps and hospitalization limits, on mental illness than on other diseases. This compassionate, forward-thinking state should not be the last to eliminate discrimination against the mentally ill.
Opponents claim that insurance parity will drive up insurance premiums to businesses, and force many to drop health care insurance altogether. It is a fair concern, but it does not square with years of actual experience in other states. Study after study has demonstrated that providing equal coverage for mental illnesses results in less than a 1 percent increase in health premiums.
Every poll shows that Americans strongly believe in insurance parity. It is not a partisan issue -- not in neighboring Washington, which overwhelmingly approved parity this year, and not in the Oregon Senate, where SB1 passed 24-5.
Yet GOP leaders have locked Senate Bill 1 up in committee, and won't bring it to the floor for a vote. For House leaders, the parity bill is the ultimate trade bait -- because it is Senate President Peter Courtney's top priority.
These lawmakers cannot seem to see beyond their political calculations or the cold actuarial analysis that has prompted some business lobbies in Salem to fight the bill. They should talk to their own neighbors who are struggling with mental illness and suffering discrimination from insurers.
Ris and Tanner live near the east Multnomah County district that House Speaker Minnis represents. Ris' son is 14; Tanner's is 16. Both women tell heartbreaking stories of long battles to get mental health care for their boys.
Ris and her husband have remortgaged their home, wiped out their savings and spent nearly $100,000 on his care. For years their lives have been a blur of emergency rooms, psychiatric wards and fights with insurers.
Once when her son was hospitalized Ris got into a bitter argument trying to persuade her insurer to cover treatment in an inpatient day facility. "I was just trying to find a place for him when he got out the hospital, a place where he wouldn't kill himself, or me," she said.
Four hours later, she says, the hospital called and informed her it was discharging her son. The insurer had cut off payments to the hospital. The explanation: If Ris' son was well enough for day treatment, he must not need 24-hour hospital care. "I learned not to argue with them," she says.
Last year, Ris and her husband had little choice but to sign partial custody of their son over to the state, which would make him eligible for inpatient care. "It was so humiliating," she said. "It made us feel like we weren't capable, not good parents." They have since regained full custody of their boy, but she says they may again have to relinquish custody: "He's starting to slide."
Tanner has testified to the Legislature about the need for parity, but she didn't tell lawmakers everything. The single mom didn't tell them how her son "has threatened to kill so many children I can't even begin to name them." She didn't tell them about spending her last dollar on his care, how the gas company shut off service, sometimes for weeks, and she heated water in a microwave to wash dishes.
Tanner didn't tell them about all the years she kept her kitchen knives locked in a toolbox on the counter, or about how she found cash in an unsigned envelope in her mailbox on her birthday, and stood in her driveway crying.
Tanner's son is eligible for a total of 15 days of inpatient care. When the troubled boy burns through that treatment -- "it goes fast," his mom said -- he is out of care. He must go home.
Only about 15 days are left in this session. If this Legislature fails to stop the discrimination against the mentally ill, if all the cynical trade deals collapse, those who are responsible will have used up all their time in the Capitol. Their failure will follow them home.
This is the 12th in the Oregon's Forgotten Hospital series archived online at www.oregonlive.com/special/
