We are beginning to see public employers exercise their right to opt out. HCFA expects that number to increase significantly over the next few months. The election to opt out of the applicable provisions of the law is typically a mandatory subject of collective bargaining. State insurance commissioners may be an ally in discouraging public-sector opt outs. Also, state and local government management level staff and other non-union staff, who would also benefit from the protections in these laws, may join forces with the union in fighting opt outs.
Public employees have the same health security concerns as other workers.
Mental Health Parity Common wisdom used to hold that mental health parity would create skyrocketing health care costs. Earlier estimates assumed 100 percent coverage under traditional indemnity plans. Since over 75 percent of workers are now covered by managed care plans, estimates were revised accordingly. Even if plans do not elect to opt out, they are not required to meet the mental health parity requirements if inclusion of those benefits would increase costs by 1 percent or more. At this time, there seems to be no consensus on the cost of this provision.