Insurance Companies Fight Against Covering Eating Disorders
Luisel Ramos, a 22 year-old Uruguayan model was most likely a size 0 when this picture was taken. Her BMI was 14.5 at 5 fee 9 inches in height; she was underweight and suffering from anorexia nervosa which eventually contributed to her death. Anorexia nervosa, a mental illness causing people to starve themselves, has the highest fatality rate of any psychiatric disorder. It is classified as an eating disorder for insurance purposes.
An estimated 11 million Americans (mostly young women) suffer from anorexia, bulimia nervosa (binge eating followed by purging) and other eating disorders. But with the economic downturn, and changes in health insurance, those with eating disorders are finding it difficult to get coverage in residential facilities, which offer the most comprehensive treatment of such illnesses, especially anorexia.
In this war between insurers who consider the residential facilities too costly (sometimes upwards of $1000 a day) and unproven, and needy patients, whose condition which has secretive components and often requires 24/7 monitoring to prevent binging and purging or just binging (compulsive overeating disorder) on foods they've sneaked in, there has been a standoff. The salvo was first fired from eating disordered patient, Jeanene Harlick, who litigated against Blue Cross Blue Shield for payment of her nearly 10-month treatment for anorexia at a residential facility. Her plan didn't include such coverage. (Shaya Tayefe Mohajer, Associated Press, Mercury News) The Ninth U.S. Circuit Court of Appeals found in favor of Hartlick, "calling on insurers to treat mental illness with the same level of care as physical illness is treated." (Mercury News)
The decision came down in August and was partly due to the 1999 California Mental Health Parity law, which the federal government and many states have enacted. The law enforces equitable treatment payments, regardless if they are for physical illnesses like heart disease or diabetes or mental illnesses like biopolar disorder or schizophrenia. Specifically, the law identifies nine mental illnesses under parity of coverage with physical illnesses. Eating disorders are included. (Mercury News)Continued on the next page