House Committee Approves Addiction/Mental Health Parity Bill

From Join Together:

In a historic move, the House Education and Labor Committee voted 33-9 to approve a strong mental-health and addiction parity bill, setting the stage for a possible House floor vote on the measure this fall.

The vote marks the first time a House committee has approved parity legislation. The bill, H.R. 1424, The Paul Wellstone Mental Health and Addiction Equity Act of 2007, is cosponsored by Rep. Patrick Kennedy (D-R.I.) and Rep. Jim Ramstad (R-Minn.). It would require group health plans with 50 members or more to cover addiction and mental health problems (as defined in the DSM-IV, the "bible" of healthcare diagnosis) on par with other illnesses.

The coverage provisions in the legislation are modeled after the Federal Employees Health Benefit Program and include out-of-network care. "This bill is about treating people equally," said Kennedy. "If you can get care for heart disease or cancer or diabetes out of network, but you can't get care for alcoholism or depression or PTSD out of network, that's not equal."

During committee debate, supporters of the parity bill beat back an attempt to amend the measure to conform with a Senate bill -- cosponsored by Kennedy's father, Sen. Ted Kennedy (D-Mass.) -- that field advocates say is weaker than the House version. Unlike the House bill, the Senate parity bill (S-558) would preempt stronger state parity legislation and give health plans the power to determine coverage levels.

"The Senate bill is the product of two years of bipartisan negotiations between a broad, well-respected group of senators, mental-health advocates, providers and business groups, who represent virtually all interests in the debate," said Rep. John Kline (R-Minn.), who sponsored the defeated amendment, CQ Today reported Sept. 18. "The House bill starts to immediately unravel support of the Senate compromise."

But Kennedy called the committee vote "a strong, bipartisan endorsement of fairness, equal opportunity, and common sense.

"It's a first step towards ensuring that anybody who pays their premiums can get the care they've paid for," he said.

Andrew McKetchnie, a spokesperson for Ramstad, told Join Together that further action on the bill probably won't occur before Congress takes its August recess, but that both the Energy and Commerce and Ways and Means Committees have pledged to act on the bill when lawmakers return in September, if not before.

If the bill clears those committees, as expected, the measure could get a vote in the full House this fall, and the margin of victory in the Education and Labor committee "bodes well for the vote on the floor," said McKetchnie.

Pat Taylor, director of the advocacy group Faces and Voices of Recovery, said she was "very excited by this important step."

"We're looking forward to passage of a strong bill," she said.

The biggest obstacle to that occurring will likely come in negotiations with the Senate, where the weaker parity bill has been endorsed by a number of prominent mental-health advocacy groups, including the National Alliance for the Mentally Ill.

Experts say that opponents of parity fall into a few main camps: people who see addiction as a moral failure; and self-insured business groups and health insurers, who think that parity will hurt their bottom line. "At this point, we have all the empirical data we need," said McKetchnie. "If people are opposing parity now, they probably will never support it."

Carol McDaid, a lobbyist for Capital Decisions who works on behalf of treatment providers and the American Society of Addiction Medicine, said the key to the measure's fate in the Senate may be "how much will the business groups be willing to give once the House passes a stronger bill?"

David Wellstone, co-chair of Wellstone Action -- an advocacy group dedicated to carrying on the work of the late Sen. Wellstone -- said he was "ecstatic" about the committee's passage of his father's namesake bill.

"I think we're going to pass this bill. I think we have some momentum," he said. "I hope the Senate will see this bill and asks why don't we get a stronger bill with better consumer protections."

Wellstone acknowledged that significant differences remain between the House and Senate bills, but showed little inclination to back down on the preemption language -- which he called "unacceptable" because it could result in up to half the states having to adopt weaker parity laws -- or using the DSM-IV to determine which conditions insurers should be required to cover.

"Health plans are looking at their quarterly investor reports," said Wellstone. "I'm looking at kids who have died."

Former first ladies Betty Ford and Rosalynn Carter called for passage of a parity law in similarly strong language in a July 18 op-ed in the Washington Times.

"As it stands now, health insurers offer coverage and reimbursement if you need cancer therapy or treatment for Parkinson's disease, heart disease, diabetes or any other physical illness," they wrote. "But if you are diagnosed with a mental illness or need treatment for an addiction, you are likely to face unequal and unfair insurance barriers that can be catastrophic to your health, your financial security and even your life. This is unconscionable. Patients affected by these disorders should be treated with the same urgency and diligence as patients with any other disease, and should receive the same healthcare options and coverage."