Bill Would Expand Treatment of Substance Abuse, Alcoholism

Bill Would Expand Treatment of
Substance Abuse, Alcoholism

A bill moving through both houses of the Legislature would require health insurance companies to cover treatment for alcoholism and substance abuse under the same terms and conditions as other diseases. The bill would have its strongest impact on the approximately 380 school districts that provide coverage outside of the State Health Benefits Program.

The Senate version (S-607) was released in January by the Health, Human Services and Senior Citizens Committee. It now awaits a hearing in the Senate Budget and Appropriations Committee before it can go to the full Senate. The Assembly companion (A-2077) was released Monday by the Assembly Health and Senior Services Committee.

NJSBA Opposition NJSBA opposes the legislation, believing that increases in medical care costs must be contained in order to control the soaring cost of health insurance. A unilateral expansion of coverage creates a scenario where local school districts may not be able to accurately budget for premium increases.

State Program The largest health insurer in New Jersey’s public schools is the State Health Benefits Program, which serves one-third of the state’s districts. The SHBP traditional program and its NJ Plus managed care alternative already meet the bill’s requirements concerning treatment of alcoholism and drug abuse. The new SHBP programs—NJ Direct 10 and NJ Direct 15—that, next month, will replace the traditional plan and NJ Plus are expected to provide coverage for the same medical treatment as do the current plans.

The HMOs that are available as options through the State Health Benefits Program provide the coverage, but they limit the number of days of coverage per occurrence.

S-607 and A-2077 would require health insurers to provide “parity” health benefits coverage for the treatment of alcoholism and other substance-abuse disorders under the same terms and conditions as for other diseases or illnesses. The bills would apply to hospitals, medical and health service corporations, individual and small employers, large group commercial health insurers, health maintenance organizations, and the State Health Benefits Program.