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KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

Bill would require coverage of eating disorders

In 1995, Rick Stream's 18-year-old daughter died in bed. For several years she'd been struggling with bulimia and that night her heart finally heart stopped beating, weakened from low potassium levels. Now, Stream is a state representative, and he's sponsoring a bill in the Missouri House that would require health insurance companies to cover treatment for eating disorders -- treatment he says could have saved his daughter's life if his insurance had paid for it.

"I'm not blaming anybody, I'm not blaming the insurance companies or anything like that," said Stream. "I'm just saying that if we'd been able to have the insurance company cover some of that treatment, she would have been in those treatment programs longer. We just ran out of money."

Residential treatment programs for eating disorders can cost between $1000 to $2000 per day, and are seldom covered by health insurance in Missouri. While the state does require some coverage of mental illnesses, including eating disorders, insurance companies often deny comprehensive treatment for disorders like anorexia and bulimia, and in many cases parents are left footing the bill, or simply opting out of treatments they can't afford.

Yesterday lawmakers in the Missouri legislature heard testimony on Stream's bill and on a companion bill in the Senate.

Annie Seal, whose daughter suffered from anorexia and bulimia, told legislators state law currently allows insurance companies determine the level of care for eating disorders.

"They actually get to decide how much treatment a patient receives, against the advice of a treatment team that may consist of a medical doctor, psychotherapist, dietician."

But opponents in the insurance industry said the bill would drive up insurance costs. David Smith, with Anthem Blue Cross Blue Shield said the more insurance mandates the government imposes, the more likely it is people will drop their coverage.

"It's not just one mandate. You've got to look at the big picture of all the mandates. As we add one and another and another, that price eventually starts to price people out of the marketplace."

This the fourth year the legislation has been introduced. In the Senate, committee chairman Scott Rupp, a Republican from St. Charles County, told bill supporters they had a "massive uphill battle."

"I could sit here and poke 200 holes in your argument and show you why this would never pass. But I can also see a roadmap to success if you fine-tune your argument." He urged them to work with the bill's sponsor to address concerns about the costs the bill would incur, perhaps adding a coverage cap.

Representative Stream said he would work with insurance companies to try to find a compromise.

"Sometimes good legislation takes three, four, five years to get done," he said. Very seldom does a bill get through on its first try."