{"id":144,"date":"2026-06-09T14:11:03","date_gmt":"2026-06-09T14:11:03","guid":{"rendered":"https:\/\/businessmovingservicess.com\/?p=144"},"modified":"2026-06-09T14:11:03","modified_gmt":"2026-06-09T14:11:03","slug":"going-home-to-die-people-with-eating-disorders-need-special-care-insurers-are-denying-it","status":"publish","type":"post","link":"https:\/\/businessmovingservicess.com\/?p=144","title":{"rendered":"\u2018Going Home to Die\u2019: People With Eating Disorders Need Special Care. Insurers Are Denying It"},"content":{"rendered":"
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\nThis reporting was supported by the Rosalynn Carter Fellowship for Mental Health Journalism.<\/em><\/p>\n

Read more Nithya Raman Knocks Out Spencer Pratt in L.A. Mayoral Race<\/a><\/p>\n

\n\tWHEN PUBERTY HIT KATERINA RINALDI in middle school, it hit hard, fast, and earlier than everyone else. Quickly, Rinaldi started gaining weight; her body started changing, too. As she puts it, \u201cI had curves.\u201d<\/p>\n

\n\tWith those curves came attention, especially from guys. Rinaldi didn\u2019t dig it. So she started dieting in the way a type-A tween might: a skipped meal here, a salad there, a bonus run in between. \u201cI didn\u2019t feel safe in that body \u2014 I felt safe in a thinner one,\u201d Rinaldi says.<\/p>\n

\n\tIn high school \u2014 an all-girls, college-prep pressure cooker typical of Washington, D.C. \u2014 Rinaldi joined the crew team, a decision that was part college strategy, part social currency, and part normalization of weight loss. \u201cIt was always just restricting and exercising,\u201d Rinaldi says. Her efforts were met with praise; teammates gawked at her six-pack in the locker room.<\/p>\n

\n\tHer doctor noticed, too. Around that time, she\u2019d started missing periods \u2014 something Rinaldi \u201cknew was part of a bigger issue,\u201d but she downplayed it. At one appointment, her pediatrician pointed out that she\u2019d plummeted off her growth curve, and asked if she\u2019d ever heard of anorexia nervosa. \u201cI laughed at her,\u201d Rinaldi says. \u201cI said, \u2018That\u2019s for thinner people.\u2019\u201d<\/p>\n

\n\tThen, college. Loneliness. Depression. Coming out. \u201cIt was a lot of change and a lot of big feelings that 18-year-old me didn\u2019t know what to do with,\u201d Rinaldi says. She skipped classes, experimented with drugs, alcohol, and took \u201chandfuls\u201d of medications, \u201cjust to see if I would feel something, just to see if it would make these really intense negative feelings go away,\u201d she says. It wasn\u2019t about getting high. It was about self-harm.<\/p>\n

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\n\tA couple of months into freshman year, things got even worse. She ate \u2014 or didn\u2019t \u2014 on a schedule. She worked out relentlessly and made herself vomit. And soon, Rinaldi found herself in and out of treatment facilities.<\/p>\n

\n\tEach inpatient course was its own saga. It took Rinaldi time to acclimate to the sterile surrounds of each unit and the heavily structured days, to trust the doctors and nurses who were treating her. She\u2019d struggle to do the one thing she, invariably, was forced to do: eat. So, hospitalizations lasted weeks, and sometimes, months.<\/p>\n

\n\t\u201cI had a lot of people give up on me,\u201d Rinaldi says. In time, she found a way through.<\/p>\n

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\n\tThat is, until insurance cut her off.<\/p>\n

\n\tOne time, Rinaldi says, Blue Cross Blue Shield denied her claims because she missed a phone call from a caseworker \u2014 and, as such, was told she wasn\u2019t engaging in her care. Another time, Rinaldi recalls that insurance denied her claims because \u2014 amid one of her rockier hospitalizations \u2014 she was labeled \u201ctreatment-resistant.\u201d Yet another time, she says, insurance cut her off because they recommended she transition to palliative care.\u00a0<\/p>\n

\n\tAs in \u201cgoing home to die,\u201d Rinaldi says.\u00a0<\/p>\n

\n\tBlue Cross Blue Shield declined to provide Rinaldi\u2019s records to Rolling Stone<\/em>, or to Rinaldi herself.\u00a0<\/p>\n

\n\tRinaldi\u2019s story is not unique. Over the past 18 months, Rolling Stone <\/em>has interviewed dozens of patients, physicians, attorneys, advocates, and lawmakers. In those conversations, experiences like Rinaldi\u2019s came up time and time again: people with eating disorders who were denied the care they needed. Rolling Stone<\/em> also obtained hundreds of pages of documents related to these patients\u2019 care journeys and insurance denials.\u00a0<\/p>\n

\n\tOften, denials occurred under the pretense of what are called, in insurance lingo, \u201cnonquantitative treatment limitations,\u201d or NQTLs. NQTLs are excuses used by insurers to justify restricting care. Insurers could deny because someone is too sick, not sick enough, or refusing care, which can itself be part of the sickness. Or they\u2019re participating in care but too unlikely to get better. Or they haven\u2019t tried less intensive care first \u2014\u00a0even though they were following instructions by their doctor.\u00a0<\/p>\n

\n\tPeople with eating disorders, advocates say, too commonly experience the worst of insurers\u2019 decisions. In Rolling Stone<\/em>\u2019s reporting, time and time again, people said they were denied care because they gained weight too slowly or too quickly, vomited too often or not often enough, or were too hard to treat. These denials have happened to the sickest of the sick. And when they go home, some of them, like Rinaldi, spiral.<\/p>\n

\n\tInsurance denials are not, by any means, limited to people with eating disorders. However, within the mental health crisis, experts say eating disorders may be the single most fatal of any diagnosis, with mortality rates up to five times higher than the general population. Youth with eating disorders die at rates up to 13 times higher.<\/p>\n

\n\tIn adults, reported rates of eating disorders more than doubled between 2000 and 2018; during the pandemic, they spiked further, and have remained elevated ever since. In youth, eating disorders have risen even more dramatically, far outpacing increases in other mental illnesses. During the Covid-19 pandemic \u2014\u00a0a time when day-to-day life was arguably disrupted more for young people than any other cohort, swapping school cafeterias and baseball diamonds for Zoom and more Zoom \u2014 the numbers skyrocketed. Studies from across the world have found rates of eating disorders, including severe eating disorders requiring ER trips and hospitalizations, rose up to 40 percent between 2019 and 2020. (Social media content glamorizing diets and fetishizing thinness like the #leggingslegs trend is only making matters worse, research shows.)\u00a0<\/p>\n

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\n\tIn at least one state, insurance companies have started denying treatment for mental health conditions, including eating disorders, at a higher rate than before, too. Since the 1980s, federal laws have sought to force insurance companies to pay for mental health treatments, like intensive psychotherapy, similarly to how they pay for physical health treatments, like hernia surgery. And though some of these denials appear to violate the law, insurers have rarely faced consequences.\u00a0<\/p>\n

\n\tFederal enforcement of the laws is limited, if it\u2019s present at all: In 2024, federal agencies had roughly 90 investigators assigned to enforcement of a law that governed coverage of 175 million Americans. (President Donald Trump\u2019s DOGE purge has exacerbated what the Department of Labor, or DOL, called \u201ccatastrophic effects\u201d related to understaffing.) Simultaneously, bills repeatedly introduced to Congress aiming to enhance regulators\u2019 enforcement authority have been repeatedly killed. Under the Trump administration, enforcement is being further hamstrung: Regulations slated for introduction under President Joe Biden were quietly walked back, and two recent bills introduced by Republicans would further limit agencies\u2019 ability to hold insurers accountable for violating the law.\u00a0<\/p>\n

\n\t\u201cAcross the country, many are dealing with a sharp rise in mental health challenges \u2014 it\u2019s critical that we help those who are struggling,\u201d says Sen. Ben Ray Lujan (D-NM). Instead, \u201cwe\u2019ve seen this administration create chaos and confusion for Americans who rely on mental health services.\u201d<\/p>\n

\n\tStates, however, have scarce capacity for enforcement. And while some states are writing new laws to protect access to mental healthcare, their ability to enforce existing \u2014\u00a0or future \u2014 laws is limited. Too often, that leaves individuals to navigate mental health care alone.<\/p>\n

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\n\tCollectively, according to Rep. Donald Norcross (D-NJ), that means \u201cpitting the average citizen of the United States \u2014 who\u2019s grappling with mental health addictions \u2014 against billion-dollar insurance companies.\u00a0<\/p>\n

\n\t\u201cIt\u2019s absolute insanity,\u201d he says, \u201cWhen insurance can ignore parity with virtually no consequences, people with mental illness are going to pay the price.\u201d<\/p>\n

\n\u2018A vicious cycle\u2019<\/strong> <\/h2>\n

\n\tFor years, Tori Peters had been pretty good at hiding her disordered eating. She\u2019d make art out of meals by pushing the food around her plate, and layering one morsel on top of the other.\u00a0<\/p>\n

\n\tThe trouble started with a choking episode at eight years old that instilled in her a fundamental fear of eating. The experience was seared into her memory \u2014 family used to mark her cups of pintos and cheese at Taco Bell with a Sharpie, to demonstrate how much she had to eat \u2014\u00a0and slowly, surely, morphed into anorexia.<\/p>\n

\n\tIn her early 20s, she got a job as a pastry chef at Disney\u2019s Grand Floridian (a surprising job for a person with an eating disorder, Peters admits), baking itty-bitty Mickey Mouse cookies, Cinderella\u2019s Castle just visible on the far side of the lagoon. Her coworkers quickly noticed how much she talked about working out and how she\u2019d take a nibble as a taste test, and spit it out afterward. Eventually, they had an intervention: \u201cIf I didn\u2019t seek help, they would have me committed,\u201d Peters recalls them saying.<\/p>\n

\n\tThat marked the beginning of a long journey for Peters, who is now in her mid-thirties. Here\u2019s how the cycle would go: Peters would be OK at home, until she wasn\u2019t. Then she\u2019d get admitted to a hospital. \u201cThey put a Band-Aid on it,\u201d she says, \u201cand send you on your way.\u201d<\/p>\n

\n\tShe\u2019d then enter a residential facility, for a number of structured days or weeks, attending group and individual therapy, rewiring her brain to eat three whole meals a day. In her case, that rarely went well. Often, the doctors would insert a feeding tube through her nose directly into her stomach to give her the calories.<\/p>\n

\n\tAt one point or another, the pounds would come back, insurance would stop paying for residential, deeming her recovered,\u00a0and she\u2019d get stepped down to a part-time program, like so-called \u201cpartial hospitalization\u201d or intensive outpatient therapy. (Both involve sleeping at home, but with extensive care at a facility.) Eventually, insurance would stop paying for that too, and she\u2019d get sent back to regular therapy.\u00a0<\/p>\n

\n\tUsually, she didn\u2019t feel ready for that transition. \u201cInsurance was kind of bouncing me around different places,\u201d Peters says. Still, sooner or later, she\u2019d be OK at home. Until she wasn\u2019t.<\/p>\n

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\n\tAccording to Susan Gray, an adolescent medicine specialist and vice chair of pediatrics at University of Virginia, Peters\u2019 experience is all too common. \u201cSome bureaucrat somewhere decides that [treatment is] no longer medically necessary,\u201d Gray says. \u201dParents are told, come pick up your child.\u201d<\/p>\n

\n\tStudies show that more than 80 percent of eating disorder patients report barriers to care due to insurance at some point during their illness, that up to half of patients leave treatment before achieving their treatment goals, and that patients with private insurance are discharged earlier than those with public insurance. (Rolling Stone<\/em> filed Freedom of Information Act requests with all 50 states\u2019 insurance commissioners\u2019 offices. None provided data specific to eating disorders \u2013 if they provided any data on mental health denials at all.)<\/p>\n

\n\tThese decisions \u201cjust creat[e] a revolving door,\u201d Gray says. \u201cIt\u2019s infuriating \u2014 you just feel powerless.\u201d<\/p>\n

\n\t\u201cIt\u2019s a vicious cycle,\u201d Peters says, \u201cand it\u2019s like that, over and over and over.\u201d<\/p>\n

\n\u2018Too many loopholes\u2019<\/strong> <\/h2>\n

\n\tThe revolving door has been an issue with American mental health treatment since it was first introduced.\u00a0<\/p>\n

\n\tIn the early 1990s, Minnesota Sen. Paul Wellstone faced this reality. After his brother Stephen, a college freshman, had been hospitalized for two years following a psychiatric crisis, Wellstone sought to sponsor a bill that would end \u201carbitrary restrict[ions]\u201d of mental healthcare by insurers. But \u201cthe business community and the insurance industry were adamantly opposed to this legislation,\u201d Wellstone wrote in his memoir. But Wellstone persevered, and in 1996, the Mental Health Parity Act passed, for the first time requiring insurers cover mental illness as they did physical illness. In theory.<\/p>\n

\n\tIt didn\u2019t take long for insurers to adapt.<\/p>\n

\n\tIn May 2000, the Government Accountability Office released a report that found that because of the law\u2019s \u201cnarrow scope,\u201d nearly 90 percent of plans had implemented \u201cdesign feature[s]\u201d limiting mental healthcare. Most patients saw \u201clittle or no increase in their access to mental health services,\u201d the GAO concluded.<\/p>\n

\n\t\u201cWe left too many loopholes for the insurance industry,\u201d wrote Wellstone, who died in a plane crash in 2002.<\/p>\n

\n\tIn 2008, Congress passed an expanded version of the law that required coverage for those suffering from addiction, called the Mental Health Parity and Addiction Equity Act (MHPAEA). In 2010, further amendments sought to strengthen the act in tandem with the passage of the Affordable Care Act. And in 2021, additional revisions targeting NQTLs, those wide-ranging exclusions \u2014 too sick, not sick enough, not engaging with care \u2014 that insurers had been using to restrict care.<\/p>\n

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\n\tYet these loopholes remain ubiquitous, Nevada Rep. Dina Titus says.<\/p>\n

\n\t\u201cA lot of people think that mental health parity exists,\u201d Titus says, \u201cso you\u2019ve got to explain to them, yeah, it exists \u2014 on paper \u2014 but it\u2019s not really working.\u201d<\/p>\n

\n\tThere are Rinaldi and Peters, both of whom say they were denied coverage for failing to progress.\u00a0<\/p>\n

\n\tThere\u2019s Marie from Pennsylvania, who has been hospitalized dozens of times since 2021 due to severe anorexia. (She requested only using her middle name for privacy.) The recent high school grad refused to eat at home and fought a feeding tube in the emergency room, even after it was placed involuntarily for her safety. But her inpatient stay was rejected by her Anthem plan in part because of inadequate \u201cwillfulness and willingness.\u201d (An \u201cintelligent clinical decision\u201d software had also determined she didn\u2019t need care because it deemed she lacked impairment in \u201cactivities of daily living.\u201d One such activity is eating.)<\/p>\n

\n\t\u201cWhile the member\u2019s family wanted her to remain in inpatient treatment, there was a lack of clinical progress, and the member was refusing medication and nutrition at that time,\u201d an Anthem spokesperson wrote to Rolling Stone<\/em>. \u201cThe information we received did not demonstrate that continued inpatient hospitalization would lead to additional progress or health improvements.\u201d<\/p>\n

\n\tThere\u2019s also Emma Sassano, an Illinois native who was denied coverage by her Blue Cross Blue Shield plan in part because she \u201chad learned to eat healthier,\u201d after gaining some weight, even as she continued to struggle with her eating disorder, according to insurance documents obtained by Rolling Stone.<\/em> She\u2019d previously developed bones so friable that they were at constant risk of breaking, and life-threatening arrhythmias from critically low electrolytes, her parents wrote in a letter to her insurer. \u201cYou were caring for yourself well enough,\u201d the insurer wrote back, in the yearslong back-and-forth that followed.)<\/p>\n

\n\tA spokesperson for Blue Cross Blue Shield declined to comment on the allegations made by Sassano, Peters, and Rinaldi. \u201cProtecting the privacy of our members is a top priority for all Blue Cross and Blue Shield companies,\u201d the representative wrote.\u00a0 \u201cWe are not able to discuss or disclose information on members.\u201d<\/p>\n

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\n\tThe NQTLs used by insurers often differ from standards of care disseminated by medical associations, explains Andrew Gerber, a psychiatrist and the president and medical director of Silver Hill Hospital, a nonprofit mental health facility in Connecticut. Reporting from ProPublica<\/em> found that insurers frequently dictated care based on proprietary guidelines developed by for-profit third-party entities \u2014 or by the insurers themselves.<\/p>\n

\nRolling Stone<\/em> obtained copies of the two most common guidelines used by insurers. One, issued by MCG Health \u2014 owned by Hearst Corporation \u2014 includes NQTLs such that patients with eating disorders who are not \u201cwilling to participate\u201d in care may be denied admission to residential facilities. The other, issued by InterQual \u2014 a subsidiary of UnitedHealth Group \u2014 says that patients who vomit less than twice daily, or those who are \u201cpreoccup[ied] with eating or weight or body image\u201d for less than four hours daily, also may be denied admission to residential facilities.<\/p>\n

\n\t\u201cSeeking treatment for an eating disorder, or any mental health condition, takes courage, and recovery can be a difficult, ongoing journey,\u201d a spokesperson for InterQual wrote in response to inquiries from Rolling Stone.<\/em> \u201cOur priority is helping people find care that fits their individual needs and circumstances, so they can stay focused on getting well.<\/p>\n

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\n\t\u201cWe use evidence-based care guidelines,\u201d the spokesperson added, \u201cwhich play an important role supporting safe, effective and appropriate treatment decisions by providing clinicians with grounded, peer-reviewed standards.\u201d\u00a0<\/p>\n

\n\tMCG Health did not respond to requests for comment.<\/p>\n

\n\tTo Gerber, the knotty nature of the guidelines is the point. Companies like MCG Health and InterQual \u201cmake it so confusing that anybody gets frustrated, bored, and then just doesn\u2019t want to deal with it,\u201d he says, \u201cand of course, every time that happens, the insurance companies win.\u201d<\/p>\n

\n\tThe more carve-outs insurers make, the less they have to pay, says Lauren Finke, senior director of policy at the Kennedy Forum, a nonprofit organization focused on promoting mental healthcare. That\u2019s especially true at more acute \u2014 i.e., more expensive \u2014 settings, like residential treatment facilities, partial hospitalization, and intensive outpatient programs.<\/p>\n

\n\t\u201dThe goal is to restrict,\u201d Finke says.<\/p>\n

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\n\tIn that way, experts say, the relationship between insurers and guideline developers appears conflicted at best.\u00a0<\/p>\n

\n\tTo Maria Monge, an adolescent-medicine doctor in Texas who treats patients with eating disorders, the rub is that the people who tend to face exclusion due to these NQTLs are amongst the sickest. The ones who don\u2019t meet numerical criteria may be better at hiding symptoms from family or clinical teams, Monge says. The ones who don\u2019t participate are the ones who can\u2019t, because their \u201ceating disorder noise is 24\/7,\u201d she adds.<\/p>\n

\n\tThat was Rinaldi\u2019s experience. After she started cycling in and out of facilities freshman year, a similar pattern would play out. Like Peters, she\u2019d be fine until she hit a breaking point, then she\u2019d get admitted. (By then, she\u2019d added calorie counting, laxatives, and diuretics to her repertoire. \u201cI was trying to make that inner hurt visible,\u201d she says.)<\/p>\n

\n\tEventually, she\u2019d physically stabilize, not infrequently thanks to a feeding tube, and that\u2019s when she\u2019d get booted by insurance, she says. At one point, she recalls an insurance representative telling her, \u201cWe\u2019re not pushing for full recovery; our goal is just medical stability.\u201d<\/p>\n

\n\tBut emotionally, Rinaldi was far from stable. She\u2019d go home, where \u201cmy day was pretty much filled with eating disorder rituals,\u201d Rinaldi says. \u201cIt was hell \u2014 I was so scared, all of the time.\u201d<\/p>\n

\n\tTo Monge, these decisions constitute clear MHPAEA violations. \u201cAs a medical provider, I can recommend every test in the book, I can get medications approved that cost thousands of dollars, and as soon as I ask for [inpatient mental healthcare], they say no,\u201d she says.\u00a0<\/p>\n

\n\t\u201cHow insurance companies are getting away with what they\u2019re getting away with is beyond me.\u201d<\/p>\n

\n\u2018Nothing more than a rounding error\u2019<\/strong> <\/h2>\n

\n\tIn September 2024, the Biden administration tried to put the use of NQTLs to an end, proposing updates for MHPAEA to curb their use. According to the administration\u2019s most recent data, more than 50 percent of adults \u2014 and nearly 70 percent of children \u2014 with mental illness weren\u2019t getting the care they needed, in part because of insurance companies. \u201cInsurers too often make it difficult to access mental health treatment,\u201d the White House wrote in a press release. \u201cHealth care is a right, not a privilege, and [m]ental healthcare is healthcare \u2014 period.\u201d<\/p>\n

\n\tThree days before Trump\u2019s second inauguration, however, an industry lobby sued, calling the new requirements a form of \u201cregulatory overreach.\u201d\u00a0<\/p>\n

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\n\tFour months later, the Trump administration suspended the proposed NQTL changes indefinitely, calling them \u201cunduly burdensome for plans and issuers,\u201d and handed over the reins on enforcement to states.\u00a0<\/p>\n

\n\tIn some ways, that recognition was a refreshing dose of honesty. According to Trinidad Navarro, Delaware\u2019s insurance commissioner, when it comes to federal enforcement of MHPAEA, \u201cthey\u2019re just not doing it.\u201d<\/p>\n

\n\tTo the extent that federal agencies enforce the law at all, the consequences are usually little more than a slap on the wrist, Navarro says. Federal agencies can only fine insurers a maximum of $100 per affected individual per day. That means that while Sassano was discharged early, the government could charge Blue Cross Blue Shield a few hundred bucks, if they were sanctioned at all. Meanwhile, Sassano was stuck with bills of more than $85,000 to date that insurance refused to pay for.<\/p>\n

\n\t\u201cThose fines, for billion-dollar companies, are nothing more than a rounding error,\u201d Navarro says. \u201cIt\u2019s de minimus<\/em> \u2014 some would consider this the cost of doing business.\u201d<\/p>\n

\n\tThe enforcement issue has been increasingly apparent to lawmakers, who have repeatedly introduced bills aimed at shoring up the federal government\u2019s ability to enforce MHPAEA. \u201cInsurers continue to find new ways to dodge compliance and deny coverage of care so they can pad their profits,\u201d Sen. Christopher Murphy (D-CT) said in a press release accompanying a 2024 reintroduction of the Parity Enforcement Act. The bill would give the DOL \u201cthe power to enforce mental health parity laws and help ensure patients get the mental healthcare they need,\u201d he added. The bill died in committee.\u00a0<\/p>\n

\n\tTwo months later, the bill was introduced again. As of this writing, it remains in limbo.\u00a0<\/p>\n

\n\t\u201cI\u2019ve never known insurance companies to do anything voluntarily \u2014 whether it\u2019s a car wreck or a mental health case,\u201d says Titus, one of the co-sponsors of the law. \u201cI\u2019m not optimistic that they\u2019re going to be magnanimous and say, \u2018Oh, let us be helpful.\u2019 If it\u2019s not enforced, it\u2019s meaningless.\u201d<\/p>\n

\n\u2018Countless violations\u2019<\/strong> <\/h2>\n

\n\tIn lieu of federal action, it\u2019s increasingly up to state legislators like Colorado State Rep. Lindsay Gilchrist to write access to mental healthcare into law.<\/p>\n

\n\tFor Gilchrist, a former foreign-aid worker focused on global health, enforcing MHPAEA protections hits close to home. Two of her daughters have dealt with mental illness and have found themselves repeatedly \u201cdumped into the black hole of insurance.\u201d In response, Gilchrist was a lead sponsor on a 2025 bill requiring insurers to follow guidelines developed by medical associations \u2014 not for-profit consulting agencies like MCG Health or InterQual \u2014 to determine care.<\/p>\n

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\n\t\u201cWe wanted doctors to make those decisions,\u201d Gilchrist says. In March, the bill became law. A handful of other states, including Virginia and California, have passed similar bills in recent years.<\/p>\n

\n\tIn New Jersey, Assemblywoman Margie Donlon, who is also a physician, has shepherded analogous bills aimed at enhancing protections where the federal government has come up short. In March, her state Assembly passed a bill that prohibits insurers from using increased body weight \u2014 a common NQTL, which Donlon called an \u201carbitrary cutoff\u201d \u2014 to deny care.<\/p>\n

\n\tIn lieu of meaningful federal action, states\u2019 responsibility for enforcing old laws \u2014 like the 2013 MHPAEA revisions \u2014 is increasing, too.<\/p>\n

\n\t\u201cWe have already found countless violations\u201d of MHPAEA, Navarro says. \u201cPeople are dying, but they aren\u2019t being murdered in a way that captures headlines.\u201d<\/p>\n

\n\tNavarro\u2019s state is not alone. Rolling Stone<\/em> reviewed hundreds of pages of documents obtained from state insurance departments whose job it is to oversee the industry. Collectively, these point to the same thing: that MHPAEA violations are widespread and often devastating for patients. In Maryland, denials of mental healthcare increased 150 percent between 2023 and 2024. In Massachusetts, almost one in four prior authorization requests for mental healthcare were denied by Aetna. (\u201cAetna has long been an advocate of the Mental Health Parity and Addiction Equity Act and improving access to mental healthcare,\u201d a spokesperson for CVS Health, which owns the insurer, wrote in a statement to Rolling Stone<\/em>.)\u00a0<\/p>\n

\n\tIn Nevada, a patient with severe bipolar disorder and depression, daily self-harm, and active suicidality was denied further treatment by Anthem Blue Cross Blue Shield due to what her mother said her plan deemed \u201ctreatment fatigue,\u201d a November 2024 complaint by her mother to the state\u2019s insurance department alleges, according to documents obtained by Rolling Stone<\/em>. \u201c[The patient] continues to end up back in the hospital because the treatment that she desperately needs is disrupted by the insurance,\u201d her mother wrote. \u201cI believe the insurance is causing the treatment fatigue as they have not allowed [her] to complete the residential program.\u201d<\/p>\n

\n\tAnthem Blue Cross Blue Shield wrote in a response to the family, \u201cThe information we have does not show the condition is likely to further improve with this care.\u201d\u00a0<\/p>\n

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\n\tHer mother wrote to the Nevada Insurance department in response, \u201c[The patient] will end up killing one of us and\/or herself which she has expressed to every provider she has encountered. [She] has followed through with her plans every time.\u201d<\/p>\n

\n\tA spokesperson from Elevance Health \u2014 Anthem\u2019s parent company\u2019s new name following a rebranding in 2022 \u2014 declined to comment on the case, citing patient privacy.<\/p>\n

\n\tDespite the toll these actions by insurers are taking on patients \u2014 and despite states\u2019 efforts to identify them \u2014 the vast majority go unpunished.<\/p>\n

\n\tA 2022 report from Georgetown University and the Robert Wood Johnson Foundation found that state efforts were often delayed or derailed by insurers. Indeed, records collected by the Kennedy Forum documented only a handful of enforcement actions since 2017. Most states, the data show, have not performed any enforcement at all.<\/p>\n

\n\tIn the rare cases when states did issue fines, they were typically on the order of hundreds of thousands of dollars. For multibillion-dollar insurance corporations, such penalties are trivial, says Deborah Steinberg, an attorney at the Legal Action Center, which helps those impacted by mental illness, among other issues.<\/p>\n

\n\t\u201cIt\u2019s pretty easy to deny treatment and make a profit,\u201d she adds. \u201cThere\u2019s absolutely no incentive for insurers to fix the barriers when they can pay a couple cents to make the issue go away.\u201d<\/p>\n

\n\u2018The most dystopian thing\u2019<\/strong> <\/h2>\n

\n\tThe cycles of force feedings, followed by weight regain, followed by denials can feel like one betrayal after another, says Sassano, the Illinois native with almost $90,000 in lingering bills that insurance refused to pay for.\u00a0<\/p>\n

\n\t\u201cI felt like the rug had been ripped out from under me,\u201d she adds. \u201cThe immediate response is panic \u2014 like, holy shit, I have to go home, I\u2019m not prepared at all.\u201d<\/p>\n

\n\tSassano says that following those cycles, she slipped back into dangerous old coping strategies. \u201cThe behaviors felt like something I could do to make myself feel better,\u201d she says, referring to restricting, bingeing, and purging. \u201cYou\u2019re incredibly raw and left with no support \u2026There are times where being cut had made me feel so hopeless that I want to give up. Like, why do I even try, I\u2019m not being given a chance?\u201d<\/p>\n

\n\tAs a doctor, that\u2019s Monge\u2019s experience, too. When insurers withhold necessary care from patients who need it, it can also disrupt the doctor-patient relationship, she says.<\/p>\n

\n
\n
\n<\/div>\n<\/div>\n<\/div>\n

\n\t\u201cWhen our work is undermined by insurance, convincing them to go back [to treatment] is an act of God,\u201d Monge says. \u201cIt\u2019s like restarting, but not even restarting, you\u2019re starting from even worse.\u201d (Studies have found that patients terminated early from treatment \u2014 either voluntarily or involuntarily \u2014 had poorer outcomes later.)<\/p>\n

\n\tStill, Peters, the former Disney baker, eventually found a doctor who could help her. And finally, she let him. After over a decade of near-death hospitalizations, that doctor told her that, despite everything he knew about science \u2014 or maybe because of it \u2014 part of her survival could only be attributed to divine intervention. \u201cIf you don\u2019t believe in a higher power, you should,\u201d Peters recalls him saying. \u201cBecause you shouldn\u2019t survive what you\u2019re putting your body through.\u201d These days, she\u2019s eating, laughing, and parenting, with another one on the way.<\/p>\n

\n\tRinaldi has also faced one obstacle after the next to fend off her illness. \u201cHaving to literally plead for your life with someone who doesn\u2019t know anything about eating disorders and can change everything with one click felt like the most dystopian thing,\u201d she says. \u201cI ha[d] to convince these insurance people that my life is worth being saved.\u201d\u00a0<\/p>\n

\n\tNonetheless, after a number of hard-fought years, she persevered. \u201dDespite insurance \u201cwriting me [off] as a hopeless case,\u201d one day, she turned the corner. \u201cOne more time was what it took to get better,\u201d Rinaldi says.<\/p>\n

\n\tToday, she\u2019s studying to be a clinical psychologist, with a plan to specialize in eating disorders. \u201cIt is my whole heart,\u201d Rinaldi says.<\/p>\n

\n\tAnd she\u2019s prepared to fight for her patients.\u00a0<\/p>\n

\n\t\u201cI want to base my whole career on having a sense of hope for people,\u201d she adds, \u201cbecause there is no single point where someone is beyond recovery.\u201d<\/p>\n

\nThis article discusses suicide. If you or someone you know is struggling or in crisis, help is available. Dial 988 or chat at<\/em> 988lifeline.org<\/em><\/strong> to reach the<\/em> 988 Suicide and Crisis Lifeline<\/em><\/strong>. Find other international suicide helplines at Befrienders Worldwide (<\/em>befrienders.org<\/em><\/strong>).<\/em><\/p>\n

\nFor help with eating disorders, the National Alliance on Mental Illness can help. Call 1-800-950-NAMI (6264) or text NAMI to 62640.<\/em><\/p>\n

Read more Hulk Hogan Cause of Death Revealed as Florida Police Investigation Closes<\/a><\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

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