By Nick Shields | Daily Herald Staff
Published: 5/27/2008 12:04 AMSPRINGFIELD -- Melissa Traub was barely a teenager when the first symptoms of anorexia surfaced. Not long after, she also began battling bulimia.
She bounced in and out of treatment programs, including several weeks at one in California.
The 24-year-old has finally found stability at the Arabella House in Naperville.
If Traub's turbulent journey to recovery wasn't enough, along the way she had another constant burden: paying for her medical care.
Her insurance provider has paid for some of the costs over the years, but Traub said she's lost count of how many thousands she's paid out of pocket. She said she believes her recovery has been slowed because more treatment hasn't been covered by insurance.
For instance, she said she's gone several years without a dietitian because it's not covered, even though some experts say a dietitian is needed to battle an eating disorder like anorexia.
"It's a hard, deadly disease," Traub said. "I would say that the eating disorder is not something that can be cured in a few weeks, maybe not in six months to a year. For (insurance companies) to not pay for it is a big struggle because most of us have had eating disorders for a while."
Traub's story isn't unusual in Illinois. The state doesn't recognize eating disorders as a serious mental illness, so health insurance providers haven't been required to help pay for her therapy bills.
But that could soon change. A law proposed in the General Assembly would add anorexia and bulimia to the list of serious mental illnesses that must be covered. Insurance companies would be required to cover 45 days of in-patient care and 60 visits of outpatient treatment.
Traub is one of more than 7 million women in the nation suffering from an eating disorder, according to the National Association of Anorexia Nervosa and Associated Eating Disorders. Another 1 million men struggle with an eating disorder, according to the association. About 86 percent of those with an eating disorder report the illness by the age of 20.
Jill Jacobe, a clinical therapist and Traub's outpatient therapist, said the people most likely to recover from eating disorders are those who have good treatment teams with a therapist specializing in eating disorders.
"Those are the ones that recover, those are the ones that don't rack up medical bills," Jacobe said. "I think that for the state of Illinois not to recognize eating disorders as a major mental illness is ridiculous."
But not everyone is on board with the legislation.
The Illinois Manufacturers' Association, for example, opposes the law and has concerns about other state mandates cropping up in lawmakers' insurance proposals. The association -- which represents the state's manufacturing industry -- said it believes there's already a litany of mandates coming from the General Assembly and it's growing out of control, helping push medical coverage costs higher for everyone.
"It's not that we don't have sympathy for eating disorders," said Jim Nelson, an association spokesman. "It's just not something that we feel employers should be paying for."
Nelson said the organization backs any employer that wants to voluntarily offer the coverage, "but government should take a look at all that they're mandating -- it drives the cost of everything."
A spokesman for Blue Cross Blue Shield of Illinois, one of the state's largest health insurance carriers, said the company has not taken a final position on the legislation but noted that mandates have an impact on the cost of care.
In 2001, state lawmakers required insurance providers to treat some mental illnesses the same as physical illness. However, eating disorders were excluded from the coverage list. Federal legislation also has been introduced in Congress that would require more coverage for mental illnesses.
In Illinois, state Rep. Fred Crespo, a Hoffman Estates Democrat who sponsored the legislation to add eating disorder coverage, said he saw first-hand the effects when he coached young female athletes. To learn more, he attended a support group and recalled one girl in particular who hasn't left his mind since that visit.
"She obviously still needed treatment," he said. "That was her last day because she ran out of insurance."
Crespo said it's unclear what the financial impact of the legislation would be but acknowledged there would be a cost. He argues it's worth it when lives are saved and hopefully a person's struggle doesn't continue for years.
Carly Cozza's struggle began when she was about 15 years old. By the time Cozza was 23, she dropped to a dangerous 60 pounds.
"I could walk, I could talk, I was stubborn, I thought nothing was wrong with me," she said. "It took a chunk of my life that's supposed to be the best years of your life."
Her journey to recovery hasn't been cheap. She leaned on the financial backing of loved ones to help pay nearly $15,000 in medical bills because her insurance company didn't cover treatment.
"I didn't go for the out-patient support because of insurance and the money wasn't there to cover it," she said. "That would be part of reason why it took me longer to recover."
These days, Cozza, 34, doesn't often step on a scale, but said she's greatly improved and hopes the law passes soon so women and men don't have to go through what she did. The Schaumburg-area resident said she's unsure what caused the illness but knows whom to credit daily for the strength to recover.
"I'm thankful to God that nothing serious happened," she said. "Look at me now."