Mental Health Parity
On September 23, the House approved, 376-47, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (H.R. 6983). The same day, the Senate approved identical provisions contained in the Renewable Energy and Job Creation Act of 2008 (H.R. 6049; seeThe Source, 9/26/08). At press time, it was unclear whether H.R. 6049 (see the forthcoming issue of The Source) or H.R. 6983 would be approved by both houses of Congress and sent to the president.
H.R. 6893 and H.R. 6049 would require insurers that provide coverage for mental health disorders to do so at the same rate at which they cover physical disorders. Parity between mental and physical illness coverage would include co-payments, 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 $3.9 billion over the next 10 years. The bill’s cost would be offset, as required by the pay-as-you-go rule, as part of the larger tax bill.
Rep. Grace Napolitano (D-CA) said, “As chair of the Mental Health Caucus here in Congress, we have been working and dealing with this issue for over 10 years. Mental health and addiction services are decades behind other services. We must recognize that the brain is part of the body and it also has rights. Stigma has always been a part of what has prevented us from being able to move forward to work for the benefit of the people. It used to be businesses indicated that family leave was going to be a detriment and costly. It turned out not to be. This has that same effect. It is going to be a saver. It is my deepest hope that this will open the gates for further legislation addressing mental health, whether addiction or other issues. Suicide is the third leading cause of death in young people aged 10 to 24. It can lead to academic failure, family conflicts, substance abuse, violence, incarceration, and alarming rates of suicide…It affects our businesses and our health industry…It affects the quality of life, and it is vital for the health and well-being of our communities and our schools. I urge my colleagues to support this vital legislation. Let’s move on and remove the stigma for mental health.”
Rep. Jim Ramstad (R-MN) said, “I am alive and sober today only because of the access that I had to treatment following my last alcoholic blackout on July 31, 1981. I woke up that day in a jail cell in Sioux Falls, South Dakota, and I am living proof that treatment works and recovery is possible. But far too many people in our country don’t have the same access to treatment that I and other members of Congress, other federal employees have.” He continued, “When my friend from Rhode Island [Rep. Patrick Kennedy (D-RI), the bill’s sponsor] and I traveled this country holding field hearings on this legislation, we heard, literally, hundreds and hundreds of stories of human suffering that ripped your heart out, broken families, tragic deaths, ruined careers, shattered dreams, all because insurance companies would not provide access to treatment for mental illness and addiction for people who were in health plans. We could change that here today. It’s time to end the discrimination against people who need treatment for mental illness and addiction. It’s time to prohibit health insurers from placing discriminatory barriers on treatment. It’s time to join the coalition of insurance companies, yes, I said insurance companies. More than 10 of them now support this, as well as the major business groups who support parity. They know it’s cost effective, they know parity saves health care dollars. It’s time to make this bipartisan legislation the law of the land. The people of America cannot wait any longer for Congress to act.”
Mentally Ill Offender Treatment and Crime Reduction Reauthorization
On September 26, the Senate approved, by unanimous consent, the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act (S. 2304). The House approved the bill on September 27. The Senate Judiciary Committee approved the legislation on March 6 (see The Source, 3/7/08).
The bill, as amended, would authorize $35 million annually for FY2009-2013 for four new grant programs, including one to provide for the treatment of women prisoners who are mentally ill. The bill also would authorize $2 million for FY2009 for the attorney general to conduct a study of the prevalence of mentally ill individuals on probation, in jail, in prison, or on parole and report its findings to Congress within 18 months of the bill’s enactment.