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House Approves Mental Health Parity, Genetic Nondiscrimination Bill

On March 5, the House approved, 268-148, the Paul Wellstone Mental Health and Addiction Equity Act of 2007 (H.R. 1424), after defeating, 196-221, a motion to recommit by Rep. John Kline (R-MN). The motion to recommit would have substituted the text of S. 558, the Senate version of the bill, which does not require employers to cover specific conditions. S. 558 was approved by the Senate on September 18 (see The Source, 9/21/07). H.R. 1424 was approved by the House Energy and Commerce Committee on October 16 (see The Source, 10/19/07), the House Ways and Means Committee approved it on September 26 (see The Source, 9/28/07), and the House Education and Labor Committee on July 18 (see The Source, 7/20/07).

Prior to voting on H.R. 1424, the House voted, 209-198, to adopt a substitute amendment, which added the text of H.R. 493, the Genetic Information Nondiscrimination Act (GINA) to H.R. 1424. GINA was approved by the House in April (see The Source, 4/27/07). The Senate Health, Education, Labor, and Pensions Committee approved its version of GINA in January 2007 (see The Source, 2/2/07); however, the bill has been placed on hold in the Senate. H.R. 493 was attached to H.R. 1424 to ensure that the genetic nondiscrimination bill would be part of any House-Senate conference negotiations over the mental health parity bills.

H.R. 1424 would require insurers that provide coverage for mental health disorders to do so at the same rate they cover physical disorders. Parity between mental and physical illness coverage would include copayments, deductibles, the number of allowed health care provider visits, hospital stay length, and annual and lifetime limits on coverage. The bill would not apply to employers with 50 or fewer employees. Additionally, the bill would not overrule state laws that have more stringent mental health care coverage requirements. The Congressional Budget Office estimates the cost of the bill at $4 billion over the next 10 years. The bill’s cost would be offset, as required by the pay-as-you-go rule, by increasing the Medicaid drug rebate rate and prohibiting physicians from referring patients to hospitals in which they have a financial interest.

Speaker Nancy Pelosi (D-CA) said, “There is no shame in mental illness. The great shame would be if Congress did not take action to ensure that individuals with mental health illnesses and addictions are given the attention, treatment, and resources they need to lead a healthy life. This is an issue of national significance. Did you know, and I found the figure startling, every year mental illness results in 1.3 billion lost days of work or school 1.3 billion days? That adds up to more lost productivity for mental illness than arthritis, stroke, heart attack, and cancer combined. Yet bipartisan and independent research shows that there is no significant cost to insuring mental illness like any other medical disease. This legislation will be especially relevant for our returning veterans from Iraq and Afghanistan who later become employed in the private sector. This will be potentially life-saving for those brave men and women who served in the National Guard and Reserves but who don’t receive VA [Veterans Administration] care for their entire lifetime. Mr. Speaker, to help remove the stigma against mental illness, for the millions suffering from mental illness and addiction, and because it is the right thing for our nation, I urge my colleagues to support the Paul Wellstone Mental Health and Addiction Equity Act. It is legislation that is long overdue. It gives hope to millions of people in our country and their families.”

Rep. Michele Bachmann (R-MN) said, “…I have serious concerns about the scope of this legislation and the impact it will have on the affordability of health insurance for all Americans. By mandating that group health plans offer the same financial benefit structure for both mental and physical disorders, the cost of insurance will increase across the board and with accessibility of health care services and the affordability of health care coverage so paramount a concern for families across the country. The Congressional Budget Office has estimated that the cost of these mandates in the private insurance market will total $3 billion annually by 2012. This will inevitably set up a cycle of increasing costs on employers offering health insurance and thus increasing costs for employees seeking to obtain coverage. These mandates may even have an adverse effect on access to mental health coverage…My colleagues in support of the bill have stressed that it does nothing to require employers to offer coverage of mental health services it only mandates what this coverage must include on those who choose to offer mental health coverage. But it is not hard to imagine that many employers who are frustrated with the increased costs the bill will impose on them will simply drop mental health coverage altogether. That, of course, would be counterproductive to the intent of the bill. In fact, it would hurt the very people the bill purports to help…Though I appreciate my colleagues’ good intentions, the negative impact this bill would have on our overall health care market is too serious to ignore and I must oppose it.”

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