Addiction, PTSD treatments could be more accessible for Californians under new law

Sep. 25--Some Californians may have an easier time accessing treatment for mental health conditions like anxiety, PTSD and addiction under a bill Gov. Gavin Newsom signed into law Friday.

The measure, Senate Bill 855, requires insurance companies to cover all mental health and addiction treatment deemed "medically necessary" by a doctor.

Federal law already broadly requires insurance plans to provide comparable coverage for mental and physical illnesses, what's known as mental health parity. California law also has parity requirements, but bill author Sen. Scott Wiener, D-San Francisco, argued they needed to be expanded.

"California's mental health parity law is completely insufficient," he said during a committee hearing on the bill last month. "It leaves out some of the most common and severe mental health conditions."

Treatments for post-traumatic stress disorder, generalized anxiety disorder, opioid use disorder, binge eating disorder and alcohol use disorder are among those not covered by the state's previous mental health parity law, Wiener said.

An analysis of the bill by the California Health Benefits Review Program found that a very small percentage of Californians would be affected by the bill, but estimated that expanding mental health and substance abuse coverage for them would increase health plan premium costs.

Monica Vera-Schubert, a Los Angeles pharmacist, thanked the governor for supporting the bill during a ceremony held over a video conferencing platform. Vera-Schubert's son became addicted to opioids after he was prescribed painkillers for having his wisdom teeth out.

She said she watched him go from a vibrant 15-year-old to a drug addict. He eventually got the treatment he needed, but only after struggling to get insurance providers to cover the care he needed, she said.

"Little did I know what hell, how our life would be turned upside down," she said. "Ten years my son has suffered from addiction. A lot of it could have been avoided if we got the proper treatment quicker."

Health insurance plans argue they already follow existing health parity laws and opposed the bill.

"California's health plans are dedicated to delivering these services," Nicholas Louizos of the California Association of Health Plans said during the committee hearing.

Newsom's Department of Managed Health Care also opposed the bill as it moved through the Legislature. The department said it supported the concept, but took issue with some provisions of the bill that it says will be difficult to implement.

Newsom had promised more enforcement of mental health parity rules. During his January budget announcement, Newsom said the Department of Managed Health Care would "aggressively" step up enforcement of existing mental health parity laws, which he argues aren't being followed by some health insurers.

At the time, he said he didn't need legislation to step up enforcement. For plans not following the rules, he promised to "deeply highlight their lack of accountability." He made that promise before COVID-19 gripped the state, and has not made any major announcements on mental health parity enforcement since.

"This is the beginning of parity, not the end," he said Friday, while also acknowledging some of the opposition to the bill. "This is a big deal. Not everyone is happy with us."

Newsom also signed the following bills related to mental health:

-- Senate Bill 803 by Sen. Jim Beall, D-San Jose, to provide peer support services for mental health conditions

-- Assembly Bill 2265 by Assemblywoman Sharon Quirk-Silva, D-Fullerton, to clarifies that funds raised by a tax on wealthy Californians to fund mental health care can also be used for substance use disorder treatment

-- Assembly Bill 1976 by Assemblywoman Susan Talamantes Eggman, D-Stockton, to make it easier to compel people with serious mental illness into outpatient treatment

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