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92_SB1341gms
State of Illinois
OFFICE OF THE GOVERNOR
Springfield, Illinois 62706
George H. Ryan
GOVERNOR
July 27, 2001
To the Honorable Members of
The Senate
92nd General Assembly
This nation has come a long way towards recognizing that
mental illness can be diagnosed and treated in much the same
way as other physical diseases. There was a time when this
was not the case. Today, there is less of a stigma attached
to mental illness than ever before and for that we should all
be thankful.
Senate Bill 1341 is one of the more complicated bills
passed during the Spring legislative session as it blends
issues of fairness for individuals with mental illness with
the broader issue of the cost of health care. Currently, in
Illinois, we are searching for ways to lower the number of
uninsured citizens. In most cases people go without coverage
because either they can not afford the premiums or their
employer can not afford to offer health insurance.
In the United States there is no mandate that individuals
purchase health insurance. While most people who do have
health coverage obtain this from their employer there is no
requirement that employers offer health insurance to their
employees. If an employer does offer health insurance, there
are no requirements on how much they can or should ask
individual employees to pay.
If a particular employer is large enough, and they offer
health benefits, they most likely will do this through an
"ERISA" program, a self-insurance mechanism that is subject
to minimal federal guidelines and completely free of state
regulation. Persons who work for a smaller employer will
most likely purchase insurance products from an insurance
company that is regulated by the Department of Insurance.
Currently, under federal law, all health insurance
products that are sold to groups must have mental health
coverage offered as an option--but the group does not have to
make that purchase. In the past few years mental health
advocates have worked hard around the country for state
legislation that would require that mental health coverage be
mandated at exactly the same levels of coverage as other
physical illnesses.
Opposition to these proposals is partly because ERISA
exempt programs cover the majority of insured citizens in
Illinois. It is thought to be discriminatory to force people
who purchase coverage from a state regulated entity to pay
for something that is not required of everyone else. This
problem is exaggerated as individuals and small groups pay
more for health care coverage.
In an attempt to address these issues the mental health
advocates and sponsors of SB 1341 have produced a bill that
is greatly watered down from past legislative efforts. This
bill would not apply to businesses with fewer than 50
employees, the provisions of this bill would sunset at the
end of 2005, and before the sunset date the Department of
Insurance must study the cost and effectiveness of this law.
Senate Bill 1341 will allow the public to grow more
accustomed to accepting mental health coverage as a part of a
solid, comprehensive health insurance package. Senate Bill
1341 allows medium and large businesses to move slowly so as
not to be alarmed by the potential cost increases of this new
coverage. And Senate Bill 1341 requires careful study of
these costs so that future decisions on this issue can be
based on facts and not anecdotes.
I have concerns about this study which, per Section
1405-30, must be conducted by the Department of Insurance.
There was no companion appropriation for the Department. The
charge to the Department seems a little vague. For example,
they must analyze "...any improvements in care of
patients..." a difficult topic for anyone to evaluate, let
alone an agency whose historic mission is the regulation of
insurance companies.
Maintenance of confidentiality is not specifically
addressed in this legislation. I will ask the Department to
work with experts in the field to make sure that
confidentiality is maintained at all times. I will also make
sure that the Department works with the appropriate outside
groups as they proceed with all aspects of this study.
With the above stated concerns clearly expressed, I am
signing Senate Bill 1341 into law while urging the many
parties interested in this difficult issue to work together
in the years ahead. If everyone cooperates there is genuine
hope that progress can be made to improve treatment for
mental illness.
Sincerely,
George H. Ryan
GOVERNOR