Proponents of mental health care parity--the requirement that insurers provide the same levels of benefits for psychiatric illnesses as they do for medical and surgical conditions--returned to the legislative fray early this year with the reintroduction of legislation that died last fall in the U.S. House of Representatives without a vote.
The bill has been renamed the Wellstone Act, in honor of the late Sen. Paul Wellstone (D-Minn.), a popular political figure and proponent for mental health care who was killed in a plane crash. The legislation has broad bipartisan support. "We have a majority of House members who have signed up as co-sponsors," Rep. Patrick J. Kennedy (D-R.I.), one of four members of Congress who introduced the bill, told Psychiatric Times. Joining Kennedy were Rep. Jim Ramstad (R-Minn.), Sen. Pete Domenici (R-N.M.) and Sen. Edward J. Kennedy (D-Mass.).
Last year, the sponsors of the bill said that the same legislation won 67 votes in the U.S. Senate but was blocked by the House leadership, who prevented it from coming to the floor.
"Our challenge this year is to break through to the leadership," Rep. Kennedy said. "We have to make sure that they follow the lead of President Bush, who spoke about this in Albuquerque, New Mexico, and Sen. [Bill] Frist [R-Tenn.], who understands so well the connection of mind and body."
Kennedy added, "Government is one of the worst practitioners with a lack of mental health parity when it comes to Medicare, which only pays 50% for mental illness but covers everything else at 80%. And, of course, as members of Congress, we've got full parity. There is a disconnect there." (Please see p28 of the print edition for more information on the 50% copayment--Ed.)
The bill expands on the Mental Health Parity Act of 1996. It would prohibit a covered group health plan from imposing treatment limitations or financial requirements on the coverage of mental health care benefits unless there are comparable limitations on medical and surgical benefits. In addition, it requires full parity for all mental health conditions listed in DSM-IV. However, it excludes substance abuse treatments from the requirement for parity.
"Substance abuse is a hopeless cause on the federal level," Erika deFur Malik, program director for health care reform at the National Mental Health Association (NMHA), told PT. "The stigma around substance abuse is so strong, and people are so afraid of risking their political careers, that they won't touch it for fear of being seen supporting a law-breaker."