Mandating Employer Coverage of Mental Health Care

Prologue: Roughly three-quarters of the estimated thirty-one million people who are uninsured in the United States work or are the dependents of employed persons. Given this and the fact that 64 percent of Americans currently receive their health insurance through their employer, the notion of requiring employers to provide insurance has become attractive to many policymakers. As legislators at the state and federal levels debate the benefits and problems of such a plan, one important aspect that bears discussing is the inclusion of mental health services. Here, economists Richard Frank and Thomas McGuire ask whether mental health care should be part of a broader health insurance mandate and look at the impact of such a requirement on the benefits and cost of coverage. Frank, who earned his doctorate in economics from Boston University, is an associate professor in the Department of Health Policy and Management at The Johns Hopkins University School of Hygiene and Public Health; a research associate at the National Bureau for Economic Research; and assistant director of the Johns Hopkins University-University of Maryland Center on Organization and Financing of Care for the Severely Mentally Ill. He also serves as a commissioner of the Maryland hospital rate-setting commission and is currently researching the public financing of mental health and the role of nonprofit organizations in funding care for the indigent. McGuire is a professor in the Department of Economics at Boston University. He received his doctorate in economics from Yale University. McGuire recently received a Research Scientist Award from the National Institute of Mental Health. His current research efforts include designing a model mental health benefits package and setting physician payment rates in psychiatry for a relative value scale.