With an estimated 8 million Americans suffering from anorexia and bulimia, state lawmakers are pushing legislation that would require Massachusetts insurers to pay the full costs of treating eating disorders.

A bill sponsored by Rep. Kay Khan (D-Newton) would add eating disorders to the state’s five-year-old mental health parity law, which requires insurers to provide coverage for treatment of biologically-based mental illnesses and emotional disorders.
“There is enough evidence today that eating disorders are a biological
illness and should be covered by this law,” Khan, a psychiatric nurse, said Wednesday at a forum sponsored by the Caucus of Women Legislators. “Without professional treatment, patients have little chance of overcoming their illness. Expanding insurance coverage will allow individuals to get the care they require to recover.”

The bill also has the support of Rep. Ruth Balser (D-Newton), chairwoman of the Legislature’s Mental Health and Substance Abuse Committee, as well as nine other representatives and one state senator.

If approved, eating disorders would be the first new illness added to the
law that now covers schizophrenia, depression, obsessive-compulsive
disorder, and other mental illnesses.

Representatives from the insurance industry say companies are currently
paying for certain treatments for eating disorders and additional
regulations are unnecessary.

“I think it’s wise to remember that health plans are already covering a
range of therapies for mental health issues,” said Marylou Buyse, president of the Massachusetts Association of Health Plans. “I’m not aware that there’s a lack of coverage for these problems.”

Buyse said she has not seen Khan’s bill, but is generally opposed to
additional mandates on insurers.

“I think it’s wise to not look at mandates as a way to encourage coverage,” she said. “All it does is force more and more employers to become self-insured which exempts them from mandates. Current law is so strong for patient protection that if there is a dispute between a member and the company, a third party will come in and evaluate the proper treatment.”

Advocates of eating disorders coverage have also sent a petition to the
state Department of Mental Health requesting that the Commissioner
Elizabeth Childs use the power granted to her by the parity law to include
additional biologically-based mental illnesses.
“Right now, a plan could have more limited coverage for eating disorders
than, say, cardiac problems,” said Clare McGorian, a Health Law Advocates attorney. “What we’re saying is that eating disorders should be put on the same level as other mental health issues.”

Dick Powers, a spokesman for the Department of Mental Health, said it is
too early to tell whether the commissioner will consider including eating
disorders in the parity law.

“The commissioner is working with advocates and other interested parties to create a process of establishing clinical criteria and a procedure for considering such requests,” he said.
Physicians at Wednesday’s forum said anorexia and bulimia are “life and
death” illnesses that require a variety of specialized services that
insurers don’t always cover.
“People with eating disorders need multidisciplinary care,” said Sara
Forman, a pediatrician at Children’s Hospital in Boston. “These illnesses
are long-term and very complex. This is not only a psychological illness,
it’s a life-threatening condition.”

According to Forman, up to 10 percent of anorexic patients will die from
their illness. Other specialists said requiring insurers to cover treatment is increasingly important as the number of men and women suffering from anorexia and bulimia grows.

“Sometimes eating disorders are seen as this fad, a bunch of spoiled brats struggling with problems,” said Dr. David Herzog, a psychiatrist and founder of the Harvard Medical School Eating Disorders Center at
Massachusetts General Hospital. “But that’s just not the case. There’s an
ever-increasing number of 50 and 60-year-olds and more and more young kids who have this.”