Mental health coverage for Alaskans is under threat

By Shirley Holloway, Richard Fagnant and Ann Ringstad

Updated: seven a few minutes ago Published: 1 One hour before

In Alaska, more than 108,000 people live with a mental health problem, more than three times the population of Juneau. Not all of these Alaskans are getting the medical care they need. Of the more than 29,000 Alaskans who did not receive the mental health care they needed last year, 42.1% did not receive care due to cost. Access to care remains a challenge for many people with mental illness in Alaska. We know it can sometimes take months to schedule a preliminary appointment with a behavioral care specialist here, especially in rural Alaska. Recent telehealth legislation passed this session will help deliver services to patients more quickly, and behavioral health caregivers are strengthening their professional staff over time to meet growing demands. But coupled with the fact that many people don’t understand their appeal rights if they experience a denial from an insurance company, filing an appeal to challenge their insurer’s denial of treatment is difficult, complicated, costly and time-consuming. time.

Unfortunately, the ability of Alaskans to receive adequate and comprehensive mental health coverage from their insurers is even more at risk. A class action lawsuit involving more than 50,000 plaintiffs, Wit v. United Behavioral Health (UBH), could negatively impact their behavioral health care coverage. In a 2019 ruling initially celebrated as a historic victory for people seeking mental health and addiction treatment, the U.S. District Court in Northern California found that UBH had created flawed criteria to determine whether it had to cover mental health and addictions treatment. This included two more than 100-page decisions describing how UBH made medical coverage decisions based on its own financial interests that were not accepted clinical standards.

Tragically, in March 2022, a decision by a three-judge panel of the Ninth Circuit Court of Appeals, which includes Alaska, overturned that decision. The new ruling would allow the nation’s largest insurer to put its own financial interests ahead of the needs of mental health patients, setting a dangerous legal precedent. The ripple effects of this case will impact health coverage for more than 130 million Americans, including Alaskans. At a time when access to care is paramount, the current decision not only disconnects clinical standards of care for mental health patients, but also limits access to care.

Resolution is possible. As a landmark case, Wit v. UBH will have a huge impact on whether health plans are allowed to continue to put their own financial interests ahead of the interests of patients in need of mental health and addictions care – allowing insurers, rather than medical experts, to dictate patient outcomes. The National Alliance on Mental Illness (NAMI) recently signed an amicus brief with the Kennedy Forum asking that the full 9th ​​Circuit Court of Appeals reconsider the panel’s decision. We urge the entire 9th Circuit Court of Appeals to rehear this case and provide critical clarity for patient parity both statewide and nationally.

Shirley Holloway is president of NAMI National. Richard Fagnant is president of NAMI Alaska, Inc. Anne Ringstad is Executive Director of NAMI Alaska, Inc.

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