Alessandra Biaggi lives with an eating disorder, and she has since high school.
Biaggi didn’t address it until she started law school at Fordham University, and even then the systemic challenges of finding care and navigating a byzantine insurance system hindered her efforts.
Now as a state senator, Biaggi is ready to change the landscape others who also suffer through such disorders have to navigate to find treatment, through a new bill that not only streamlines the treatment process, but properly defines the disorder in the first place.
“An eating disorder is something you live with every day,” Biaggi said. While at Fordham, she made a list of outpatient eating disorder specialists in the city and began calling. Places were full or didn’t accept insurance. Sometimes, a person would pick up the phone and be downright cold and unkind.
Biaggi persisted, crediting an obsessive aspect of her personality that would not let her stop searching.
“Not only is not everybody like that, but not everybody has the time,” Biaggi said. “If you’re talking about someone who is working and has a full-time job … they don’t have time to be on the phone all day long finding help. They need to be able to say, ‘Here’s my insurance, can you help me?’”
Biaggi believes she would not be a state senator writing new legislation mandating insurance companies cover treatment for all eating disorders had she not had the advantages she had when pursing treatment in law school.
“It’s not something that goes away,” she said.
State law currently defines eating disorders as either bulimia — binge eating and purging — or anorexia, an unhealthy obsession with getting skinnier. It’s part of Timothy’s Law, passed in 2006 intended to require insurance companies to cover mental health as much as they cover physical health.
But with the bill Biaggi supported awaiting Gov. Cuomo’s signature, there will be at least a dozen more disorders that could now be covered.
When signed into law, the bill would add issues like pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, binge eating disorder, and “any other eating disorder” in the most recent version of the American Psychiatric Association’s diagnostic manual.
“People who were suffering from eating disorders in a complex way … would not be able to get treatment,” Biaggi said. She estimates the out-of-pocket cost of treating uncovered eating disorders could get as high as $30,000 month.
“That number alone completely carves out most people from being able to get treatment.”
Queens Assemblywoman Nily Rozic first authored this bill back in 2017, only to be stonewalled by a divided senate. Democrats retook the state senate in 2018, in no small part to Biaggi’s victory over Independent Democratic Conference leader Jeffrey Klein. Now, Rozic had majorities in both chambers, and a champion for her bill — in the form of Biaggi — in the senate.
“Eating disorders are real, complex, devastating conditions that affect health, productivity and families across New York,” Rozic said in a statement. “Eating disorders are highly treatable with affordable medical care that doesn’t leave families choosing between bankruptcy and recovery. I am proud to have championed this crucial, life-saving legislation.”
The National Eating Disorder Association estimates 20 million women and 10 million men in the United States are living with an eating disorder at any given time. The association helped lobby for the passage of this bill, bringing activists and constituents up to visit with lawmakers each year.
The association’s chief policy officer, Chevese Turner, said they are fighting for this type of legislation across the country.
“This is a law that has articulated some really important clarifications,” she said. “Families who are affected by eating disorders not uncommonly get themselves stuck in a maze where particular language … can really have a dramatic impact on the curative need available.”
Another female state senator who won her seat in 2018 became an unlikely voice of opposition to the bipartisan bill. Upstate Republican Daphne Jordan was the legislative director for her predecessor, Kathy Marchione, the senate sponsor of the bill when it could not even get a floor vote. Jordan supports broadening insurance coverage for eating disorders, but is worried about the impact this bill would have on state-funded treatment centers.
“I’m all too familiar with this bill,” Jordan said on the senate floor just before it passed by a 53-8 margin. She called for public hearings and aired concerns the bill was a piece of cookie-cutter legislation being pushed in state houses across the country by the eating disorder association.
“I think we need to evaluate the system we already have in place before passing this bill and look at New York state statistics, not just the national statistics that this bill is based on,” Jordan said.
Biaggi is less concerned with the financial complications expanded coverage may bring and more concerned with the impact this legislation will have on those living with eating disorders. Multiple studies found anorexia nervosa is the mental disorder with the highest mortality rate. According to one study out of the University of Leicester, those living with anorexia nervosa had a mortality rate six times higher than the general population.
“Nothing is life and death, but life and death,” Biaggi said. “This bill could be the difference.”