New York Gov. David Paterson announced new legislation that would make the state’s “Timothy’s Law” expanding mental health insurance coverage permanent.

Timothy O'Clair

“Timothy’s Law,” named after the late Timothy O’Clair, requires insurers issuing group or school blanket health insurance policies or contracts to provide a minimum of 30 inpatient days and 20 outpatient visits to treat mental health conditions, also known as a 30/20 benefit. The law also requires large group health policies to provide coverage for adults and children diagnosed with biologically based mental illness and children diagnosed with serious emotional disturbances at the same level of coverage as is provided for other health conditions.

The law took effect on Jan. 1, 2007, and is set to expire Dec. 31.

New York State’s Insurance Department, in consultation from the state’s Office of Mental Health, also issued a report on mental health required under Timothy’s Law.

Among the findings of the report were that access to 30/20 benefit increased from 42% to 100% in the combined large and small group markets and from 9.6% to 43.7% in the small market and from 11% to 100% in the large group market regarding access to coverage for biologically based mental illness and serious emotional disturbances in children beyond the 30/20 benefit.

New York State Insurance Superintendent Eric Dinallo said the report shows that Timothy’s Law “has been a success.”

“Since the state now fully subsidizes all mandated mental health benefits for small businesses through the state’s Timothy’s Law Fund, small businesses do not pay for this increased benefit,” he said. “This is particularly important, as small businesses are especially sensitive to health insurance cost increases.”

O’Clair was a 12-year-old from Rotterdam, N.Y., who committed suicide in March 2001 after his parents were unable to obtain mental health treatment for him due to health insurance coverage limits.

Paterson said he was proposing the extension of the law on what would have been O’Clair’s 21st birthday in his memory.

“Timothy’s Law has provided countless New Yorkers with the mental health coverage they need to remain healthy and be productive residents of our state,” Paterson said in a statement. “The impact of Timothy’s Law has been far reaching, going beyond the requirement that health insurance cover treatment for mental health conditions, to help eliminate the stigma surrounding mental illness and those with mental health conditions that too often cause people to go without the care and treatment we know is effective.”

O’Clair’s parents, Thomas and Donna, thanked the governor for honoring the memory of their son and his dedication to help others.

“While making Timothy’s Law permanent will not bring my son back, it will allow those millions of New Yorkers who also face mental illnesses to get the treatment they need.,” Thomas O’Clair said.

At the federal level, Timothy’s Law is strengthened by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, passed in October 2008.
The act does not mandate that employers provide coverage for mental health benefits, but instead requires those large employer groups that do provide mental health benefits must do so in full parity with other medical benefits covered under the policy.

When the act takes effect this October, Timothy’s Law will mandate that large-group policies provide mental health benefits, and the federal act will require that any such mental health benefits provided by large-group policies be in full parity with other medical benefits.