Without help, the 16-year-old struggling with anxiety and depression issues withdrew to her room once again.

Utahns with mentally ill family members regularly face the same dilemma, but now a new federal law has given them hope. Included in the financial rescue package, the law required insurance plans that offer mental health benefits to make them equal to physical health benefits, in group insurance covering 50 or more people.

"Then my kids can get the actual treatment they need and I don't need to be on suicide watch with them all the time," Jensen said.

But exactly how the law will reshape insurance plans in Utah is unclear. Major insurers said they may not need to make significant changes to their coverage in light of a Utah parity law passed by the Legislature in 2000.

Families often face different deductibles for mental health and medical coverage, forcing them to make difficult choices, according to Robyn Emery, a family advocate with the Utah office of the National Alliance on Mental Illness.

"You either eat or you pay," said Emery, who herself has different mental health and medical coverage.

Yet SelectHealth, the insurance arm of Utah's largest health care provider, Intermountain Healthcare, does not foresee any changes in its coverage.

"Mental and medical health have been covered at the same rate in Utah since 2000," said Jason Burgess, spokesman for SelectHealth, the largest health insurer in Utah. "From what we can tell, the components of this [federal] bill have already been implemented in Utah."

The 2000 law was, however, limited in its reach, leaving many Utahns without parity in mental health benefits, according to Sherri Wittwer, executive director at Utah's National Alliance on Mental Illness.

Under the 2000 Utah law, the Catastrophic Mental Health Parity Statute, commercial insurance plans covering 50 or more people cannot put different limits on mental and physical health coverage. But it also does not require mental health coverage in medical insurance plans.

Tauni Everett, of Regence BlueCross BlueShield, the second-largest health insurer in Utah, said the federal law may affect plans from her company that limit the number of visits per year to a mental health care provider. She said dropping those provisions likely would lead to more visits to providers, increasing costs and, therefore, premiums.

"Once coverage changes people tend to use it more," she said. "That drives up the cost."

Kelly Atkinson, executive director of Utah Health Insurance Association, called the new federal law "dumb." Atkinson pointed to the Utah law, which he claimed caused companies to dump mental health coverage that paid 50 percent of the cost of care, rather than assume the extra cost of the required parity.

Other companies became self-insured so they did not have to comply with the state law, he said.

However, a state study showed that mental coverage actually increased slightly and that people tended to visit outpatient caregivers more often after the Utah law was implemented.

"What that suggests is the availability of coverage allows you to get outpatient services, which are usually less expensive, rather than having a crisis and going to inpatient care. It suggests the quality of care improved," said Jeff Hawley, research analyst for the health division of the state Insurance Department. The department is charged with enforcing insurance laws, such as mental health parity.

The study, which covered the years 1999 to 2002, showed that claims paid for mental health coverage rose from 1.3 percent of all claims in 1999 to 2.2 percent in 2002, meaning the cost rose for insurance companies.

jlyon@sltrib.com,

tharvey@sltrib.com

Major health insurers in Utah

Below are the names of the insurers, followed by their market shares.

* SelectHealth Inc.: 3 percent

* Regence BCBS: 20.29 percent

* Altius Health Plans Inc.: 17.19 percent

* United Healthcare: 8 percent

* Healthwise: 4.28 percent

*Numbers for 2006, the latest available

Source: State Insurance Department