In the month since new regulations governing mental health parity went into effect, several insurance companies have complain...Read more
Mental Health Parity: A Tale of Two Bills From the Same Family
- April 10th, 2007
Dinner conversation with the Kennedys would be interesting these days, as Sen. Edward M. Kennedy (D-MA) and his son, Rep. Patrick J. Kennedy (D-RI) are advocating differing mental health parity bills. These related members of Congress both seek a law that would provide people with mental or substance abuse disorders the same benefits from their health plans as those who suffer from physical illness. Currently, insurers and health care providers may offer lesser benefits to those who suffer from non-physical ailments. Although the two Kennedy bills share a common goal, their provisions are very different.
Sen. Kennedy, along with Sen. Pete V. Domenici (R-NM) and Sen. Michael B. Enzi (R-WY), is sponsoring the 'Mental Health Parity Act of 2007.' To increase support for the bill, the concerns of employers and insurance companies were taken into consideration during the bill's drafting, and a Senate committee recently approved the measure by a vote of 18 to 3.
Meanwhile, Rep. Kennedy and Rep. Jim Ramstad (R-MN) are promoting 'The Paul Wellstone Mental Health and Addiction Equity Act,' named for the late Minnesota Senator who promoted the legislation before his death in a plane crash in 2002. The House bill has not received much support from the business sector but is backed by 60 percent of House members.
Both the House and the Senate bills would apply to group health plans that cover 50 people or more. The House bill requires health plans offering mental health benefits to cover the same mental illnesses and addiction disorders that are covered in the health program that covers the members of Congress, the Federal Employees Health Benefit Program. The Senate bill, on the other hand, leaves it up to employers to decide which mental disorders they would cover. Thus, the House bill would offer broader access to treatment for alcoholism and drug abuse, a difference that the younger Kennedy believes is a weakness in his father'™s bill.
The House bill also eliminates differences in co-payments, deductibles and out-of-pocket limits between mental health and medical or surgical benefits. For example, if a co-payment for a high blood pressure drug is $10, then a co-payment for an antidepressant drug must also be $10. Or, if a health plan offers unlimited doctor visits for colds or broken bones, then there cannot be a cap on the number of therapy sessions that would be covered.
Another difference between the bills is how they affect related state laws. Where the House'™s bill allows states to set stronger laws and protections if they wish, under the Senate'™s bill a state'™s law would be preempted by the federal mental health parity law. Currently, 48 states have some form of parity laws enacted.
Amednews.com reported recently that supporters of mental health parity legislation "are optimistic that with Democrats in power in the House and Senate, a final bill will reach President Bush this Congress.' This echoes Sen. Kennedy, who the The New York Times reports is "confident that he and his son could resolve their differences," quoting the Senator as saying, "We will find ways of working together.' Amednews stated that 'Bush has not commented on the legislation but has supported mental health parity in general.'
To read the House bill, go to:http://thomas.loc.gov/cgi-bin/query/z?c110:H.R.1424:.
To read the Senate bill, go to: http://www.cbo.gov/ftpdocs/78xx/doc7894/s558.pdf .
For more on the Federal Employees Health Benefit Program, go to: http://www.opm.gov/insure/health/.
To read the Amednews.com article, go to:http://www.ama-assn.org/amednews/2007/03/05/gvl20305.htm.
Last Modified: 04/10/2007