New Jersey Parity Coalition Uses Multi-Pronged Strategy to Fight Insurance Plan Inequities

Picture of Aaron Kucharski

Aaron Kucharski, New Jersey Parity Coalition

 What happens when there are laws on the books granting you equity, but when you try to use them as intended, you meet nothing but obstacles? That’s what many family members in New Jersey were asking when they tried to take advantage of the new mental health parity laws that increase access to care. Among those individuals was Valerie Furlong, who was seeking care for her two teenage sons. When she connected with other family members facing similar challenges, Valerie quickly learned that she was not alone in her frustration. She and others like her decided to take action against these obstructions and join forces with the New Jersey Parity Coalition.

A legislative solution
When advocates first broached the issue of mental health parity in New Jersey, there was some confusion, not surprisingly, because state legislators thought that the federal law had solved the problem. This notion that the federal law was a panacea for inequity was further perpetuated when the federal government issued final regulations implementing the law in 2012. Though it is true that the federal law and regulations are applicable at the state level, many health insurance plans have been slow to implement them. In response to the problems in our state, advocates in New Jersey are embarking on a legislative fix strategy to increase local oversight and compliance of parity implementation.

One push for greater regulation is coming from the New Jersey Parity Coalition. The Coalition began as an idea in South Jersey among advocates, concerned family members, treatment centers, and nonprofits.  Now, the Coalition has spread statewide with the goal of ending insurance benefit inequalities. This statewide Coalition is moving closer to having a bill to ensure compliance introduced in the New Jersey General Assembly.

The Coalition is confident about bipartisan support of the bill and is thinking strategically about co-sponsors. Similar to the legislative win in Illinois, there may be an opportunity to include parity as part of a larger bill that addresses the opioid addiction crisis in New Jersey. This strategy could also garner support from Governor Chris Christie, who has been a vocal supporter of substance use disorder services.

Making it personal
Another key team within the Coalition is the Denials Committee. Using the email address denied.treatment@gmail.com, this team collects stories from families, individuals, and agencies about mental health benefits they believe have been incorrectly denied to plan beneficiaries. It is the goal of this Committee to have a meeting with the New Jersey Attorney General to share these stories—putting a personal face on the problem so many families in New Jersey face every day.

Education as part of the solution
Effective enforcement of the law, however, depends upon an educated public. The regulatory body in our state is the Department of Banking and Insurance (DOBI). One major obstacle to enforcement revolves around language. DOBI employees don’t always recognize parity violations because the individual contacting them does not use legislative language. Seldom does anyone call the DOBI and say, “I have a parity issue.” Instead they say they were denied mental health and/or substance use services.

That statement alone on its face does not signal a red flag and even employees within the DOBI don’t always identify these complaints as parity violations.

In order to address this seemingly simple issue, the Coalition is working to create more community outreach. Most notably, the Coalition has provided two educational workshops that focus on informing people about their rights and how to file an appeal. These workshops were delivered to communities around the state in June 2016. People who are interested in a training by the New Jersey Parity Coalition can email us at NJparitycoalition@gmail.com.

Much work needs to be done in New Jersey to recognize the promise of the 2008 federal parity law.  Sadly, several family members participating in the Coalition have lost loved ones while waiting for the state to take action, yet many of those individuals are still committed to the work of the Coalition because one life lost is one too many. 

Editor’s Note
Coalition member, the Depression and Bipolar Support Alliance (DBSA) also provides an educational presentation to New Jersey and Pennsylvania organizations. The presentation provides real-world scenarios to help people better identify a disparity when it arises, and provides them the language to communicate with their insurance plan and a state’s regulatory agency. If you are interested in hosting a training on mental health parity in either of these states, please contact Carol Rickard, DBSA Community Education and Outreach Consultant at: crickard@dbsalliance.org

Your Turn

  • If you or a family member have been incorrectly denied access to mental health care, what happened and what did you do about it?
  • How are you evaluating your plan to understand if you have been incorrectly denied care?

Bio
Aaron Kucharski is the National Council on Alcoholism and Drug Dependence-New Jersey’s (NCADD-NJ) Advocacy Coordinator. He was the National Grassroots Coordinator for the historic UNITE to Face Addiction event in Washington DC in 2015, which saw the mobilization of tens of thousands of people to end the silence on addiction. Prior to his work with the NCADD-NJ Advocacy Program, Aaron was a field organizer for Faces and Voices of Recovery during its 2008 “Recovery Voices Count.“ Additionally, he has participated in a number of state efforts in Rhode Island with Rhode Island Communities for Addiction Recover Efforts (RICARES) from 2008-2010, and has helped organize the recovery community in more than a dozen other states.  Aaron is a person in long-term recovery, which means he has not had a drink or drug since September 6th of 2003. Aaron formerly served on advisory committees to NCADD National and Faces and Voices of Recovery, and is currently a board member for Young People in Recovery.

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