Eating Disorder Legislation to Take Effect Jan. 1
During my 14 years in the General Assembly, I have worked to pass legislation that promotes and protects our state resources and, most importantly, the well-being of the men, women and children who call Missouri home. One area that is absolutely critical to the overall health and safety of our citizens is mental health — sadly, it is also an area that does not receive the attention, or funding, it deserves. That is why I have sought to use my platform as a state senator to advocate for the mental health community and raise awareness about mental illness.
In 2015, I helped lead the effort to pass Senate Bill 145, which requires health insurance plans to provide coverage for the diagnosis and treatment of eating disorders, the most common of which are anorexia nervosa, bulimia nervosa and binge-eating disorder. An estimated 500,000 Missourians — of all different backgrounds and socioeconomic status — are thought to suffer from an eating disorder, so chances are you know someone who is battling, perhaps silently, one of these devastating illnesses.
Although eating disorders usually appear during teen years or young adulthood, they can develop in childhood or later in life. According to the National Institute of Mental Health, eating disorders affect both genders, but appear at more than twice the rate in women as they do in men. If left untreated, eating disorders can lead to osteoporosis, weakness, heart damage, gastrointestinal issues, organ failure, numerous other complications and even death. Suicide is also a major cause of premature death among individuals with eating disorders.
The good news is eating disorders are treatable, and complete recovery is possible if patients are able to receive the professional help they need. Since eating disorders can involve a wide array of both physical, psychological and social issues, treatment generally involves a multi-faceted approach and can be a lengthy process. Before SB 145, a lack of specific guidelines allowed insurance companies to take advantage of loopholes and limit or deny care, often resulting in high out-of-pocket costs for those receiving treatment. And since a patient’s weight could be used to determine whether further treatment was needed, patients would sometimes be dismissed from their treatment programs prematurely.
Under SB 145, insurance companies will be required to provide coverage for a patient’s medical care, psychological care, psychiatric care, nutritional care, pharmacy care and therapy. The act further requires coverage to include a broad array of specialist services as prescribed as necessary by the patient’s treatment team. Perhaps most importantly, SB 145 mandates that medical necessity determinations and care management must consider the overall medical and mental health needs of the patient and shall not be based solely on weight. Signed into law in June 2015, I am pleased to say SB 145 will finally take full effect on Jan. 1, 2017 — the date by which all health insurance plans must be in compliance.
Prior to SB 145, I sponsored legislation in 2010 to also call for insurers to cover eating disorders and establish the Missouri Eating Disorders Council within the Department of Mental Health. While the insurance coverage portion did not pass at the time, the provision establishing the council did. Since then, the council has been charged with overseeing eating disorder education and awareness programs and is empowered to identify whether adequate treatment and diagnostic services are available in the state.
Of course, I cannot talk about SB 145 without mentioning the Culp family of Warrensburg. In May 2009, Laura Culp passed away from a heart attack after battling an eating disorder for 13 years. Afterwards, her parents, John and the late Sandy Culp, worked with Missouri lawmakers to get eating disorder legislation passed. It took seven years, but the Culp family, and many other families, never stopped fighting on behalf of their loved ones and all those affected by an eating disorder. They made it possible for SB 145 to become law, and the people of Missouri owe them all a debt of gratitude.
With the passage of SB 145, Missouri became the first state in the nation to establish specific guidelines for how insurance companies must cover eating disorders. Senate Bill 145 truly has the ability to save lives, as it will give thousands of Missourians the opportunity to access affordable, quality health care. As I prepare to leave office, I cannot think of a better way to cap off the end of my Senate career than seeing this important legislation take effect.
As always, please feel free to contact me or my staff with any questions or concerns at any time. We look forward to hearing your comments and suggestions and trying to answer any questions you may have. You can reach us by phone at 866-277-0882 (toll-free) or
(573) 751-2272, or by fax at (573) 526-7381.
Senator David Pearce serves Caldwell, Carroll, Howard, Johnson, Lafayette, Livingston, Ray and Saline counties in the 21st State Senatorial District.
Capitol Office, State Capitol Building, Room 227, Jefferson City, MO 65101
Phone #: 866-277-0882 (toll free); 573-751-2272