Americans who suffer from an eating disorder face enormous physical, emotional, and mental hurdles — and with spotty insurance coverage, they face the added burden of significant financial hurdles as they try to cope with their disease.
As Kaiser Health News reports, the complex, often wide-ranging nature of eating disorder treatments often leads insurers to skimp on benefits, and state and federal consumer protections do not go far enough in ensuring sufficient coverage for Americans with anorexia, bulimia, and other eating disorders:
According to the Eating Disorders Coalition, a lobbying and advocacy group based in Washington, D.C., 14 million people are affected with anorexia, bulimia and binge eating disorder. And for many of these patients, getting a full range of insurance coverage can be difficult. Mental health coverage is often less generous than coverage for physical ills. In addition, helping eating disorder patients is complicated because it involves medical care, mental health services and nutritional therapy, requiring a team of specialists – often a primary care doctor, a therapist, a psychiatrist and a dietician. Patients argue that insurers don’t adequately cover all those services.
The coalition tried unsuccessfully to get eating disorders included in the “essential health benefits” the health overhaul law requires insurers to provide beginning in 2014. “Exclusion of eating disorders is all too common on the part of insurers seeking to limit interventions deemed non-essential,” the group wrote to federal officials in a in a January letter. “Despite being biologically based mental illnesses with potentially severe physical health ramifications, including death, eating disorders are all too often found on lists of benefit exclusions.”
The group noted that a survey of more than 100 eating disorder specialists found that “96.7% believe their patients with anorexia nervosa are put in life threatening situations” because treatments often are cut short when coverage is denied.
In an age of advertising campaigns that are increasingly leading to unhealthy body image issues in young girls — 80 percent of 10-year-old girls say they have been on a diet — these lapses in adequate insurance coverage for eating disorders should not be taken lightly. And although some states provide comprehensive coverage for mental as well as physical health problems, most have stratified levels of care depending on predefined categories of “mental health problems” — a system that, by some estimates, leads to only one in ten eating disorder patients receiving treatment.
Obamacare mandates that any coverage plan offered under the health law’s new statewide insurance exchanges in 2014 must meet federal benchmarks across ten benefit categories, including essential expansions to prescription drug, maternity care, and mental health services. Unfortunately, eating disorders are a particularly complex medical issue, and Obamacare largely leaves the definition of a required “mental health service” to the discretion of the states and insurance companies.