Georgia insurers fail to prove compliance with mental health law

By Katherine Landergan and Maya T. Prabhu, The Atlanta Journal-Constitution

Last year, state officials fired a warning shot to insurance companies that operate in Georgia: All insurers, they said, must treat mental health services the same as physical health.

Now, one year later, a report from the insurance commissioner shows that not a single insurer has proven it is doing so, according to the state’s insurance department.

“Until this report, we didn’t know what the insurers were doing. So now, we have a baseline. And we’ve got a long way to go,” said Whitney Griggs, a senior policy manager at Georgians for a Healthy Future, a group that pushed for the changes.

In 2008, the federal government enacted a law that said insurance companies were to cover mental health care the same way they do for physical health care. Advocates say anecdotal evidence has shown that companies have skirted this law, and so, Georgia put in place its own law, HB 1013, that would require insurers prove compliance.

Georgia ranks low nationally on most measurements of mental health treatment and high in the percentage of residents who face challenges. Fixing the issue was a priority of late House Speaker David Ralston, a Blue Ridge Republican, who called it one of the most important bills lawmakers would vote on in their careers. The law went into effect in July 2022, and several months later, Ralston died.

Here’s an example of how the law should work when a company is compliant: say a person enrolled in an insurance plan has unlimited doctor visits for a chronic condition like diabetes. Then, that plan must also offer unlimited visits for a mental health condition, such as depression or obsessive compulsive disorder.

But a report shows that none of the 28 insurers in Georgia who are required to prove they are treating mental health the same as physical health provided sufficient information, and are therefore potentially violating the law. The report, from the department of insurance, was sent in August to Gov. Brian Kemp, Lt. Gov. Burt Jones, and House Speaker Jon Burns.

What’s more, an additional 24 insurers did not respond to the department’s call for information. Several hundred companies, such as life insurance, were found to be exempt from the requirement.

The department says it will further press insurers for information showing how mental health services are being covered the same as physical health, and has recommended deeper dives into an insurer’s compliance. Legislators also have planned ongoing discussions with John King, Georgia’s Insurance and Safety Fire Commissioner, according to state Rep. Mary Margaret Oliver, a Decatur Democrat.

Oliver, who co-sponsored last year’s bill, said that the legislation is still early in the process. She and other lawmakers are not yet discouraged by what seems to be the lack of information shared with the insurance department.

“Parity is one real target of the work we need to do,” Oliver said in an interview. “It’s not a new target. It has been part of conversation since at least 2008. But I think we now have the tools to effect change.”

But advocates that lobbied for the law expressed their frustrations with the lack of information provided by companies, and the state.

“If they aren’t going to be providing the data, then we have no basis to assume that anything has changed in connection with getting better and more timely access to behavioral health care,” said Roland Behm, a board member of the Georgia chapter of the American Foundation for Suicide Prevention.

Dr. Eve Byrd, director of the Carter Center’s Mental Health Program, said this report shows that more must be done to ensure compliance.

“One message that I think is important that our policymakers hear is that the passing of legislation will not in and of itself, get the job done. ... so the state needs to continue to provide the resources necessary to implement this legislation,” Byrd said.

Senate Health and Human Services Chairman Ben Watson, a Savannah Republican and physician, said it’s important to get more information so the Legislature can determine the next best steps to take in mental health.

“We need to see if there’s something that we need to tighten up with legislation to help (insurance companies) understand it,” Watson said. Or if we need to provide sanctions (for noncompliance), which, certainly I would not want to do, but they need to get us the data so we can make some reasonable recommendations.”

Oliver said she was encouraged that so many lawmakers and advocates continue to be engaged in the mental health law.

“I have always felt the biggest fault of legislators is not following up on a bill that we’ve passed,” she said. “That is not a mistake we’re going to make [with this law].”

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