Treatment Funding and Parity

The Milwaukee Addiction Treatment Initiative will continue to advocate for treatment funding reform that ensures that everyone in Wisconsin has access to high-quality health insurance, not only on paper but also in reality.

Ensuring Everyone in Wisconsin Has High-Quality Health Insurance

Wisconsin leaders have successfully expanded the BadgerCarePlus health insurance program to cover more low-income children and adults, including childless adults, than ever before. Despite this recent expansion, nearly 500,000 people in Wisconsin are still uninsured -- roughly 8 percent of the population. The uninsured suffer from poorer health and higher rates of premature death than insured adults, receive less preventive care and are diagnosed at more advanced diseased stages. The uninsured cannot access sufficient addiction treatment.

MATI advocates at the state and national level for full implementation of the federal Patient Protection and Affordable Care Act to:

  • Guarantee that everyone has health insurance with good benefits and a wide choice of plans and providers.
  • Ensure the availability of preventive and chronic care without deductibles, co-pays and co-insurance.
  • Provide that addiction treatment on a parity basis (see below).
  • Include an effective mechanism for controlling the growth of health care costs.

Ending Discriminatory Insurance Policies

Treatment works—while addiction is not curable, millions of people with addictions have been successfully treated. However, insurers routinely discriminate against people seeking addiction treatment by providing limited coverage, restricting the number of visits to treatment facilities and requiring excessive cost-sharing, deductibles and out-of-pocket costs.

Addiction treatment should be covered at the same level as chronic physical illnesses such as Type I diabetes, hypertension and asthma. Anything less is discrimination.

There have been recent advances in parity provisions:

  • The federal Wellstone-Domenici Mental Health Parity Act may bring these discriminatory practices to an end. Passed in October 2008, the law states that insurers who offer coverage for mental health and addiction treatment must offer it to the same degree as physical treatment, i.e. without artificial limits and cost sharing. MATI will be vocal in its support for broad application of Wellstone-Domenici, both to BadgerCarePlus as well as private insurance.
  • The Wisconsin Parity Act, which became law in April 2010, requires commercial group health plans in Wisconsin to provide mental health and addiction benefit coverage at parity levels. We will continue to work with state policymakers to ensure that the Wisconsin Parity Act is implemented in accordance with the spirit of the law so that parity-level commercial group health insurance coverage for the treatment of mental illnesses and substance use disorders will become a reality.
  • A major feature of the federal Patient Protection and Affordable Care Act is a requirement that all individual and small group health plans provide an essential health benefits package that includes mental health and substance use disorder services. In addition, these plans must comply with the Wellstone-Domenici Act requirement that mental health and substance use benefits be provided on an equal basis with other covered medical and surgical benefits.

We will continue to work to ensure that parity requirements at the state and federal level are fully realized in insurance plans.