Pressure the House on Mental
Health Parity
August 16, 2005
Action Needed
Join with NASW’s advocacy partners and call your Representative,
using the toll-free Parity Hotline, 1-866-parity4 (1-866-727-4894),
to urge cosponsorship of the new House mental health parity
legislation, H.R.
1402. (The Parity Hotline reaches the Capitol switchboard,
which can connect callers to their Members of Congress.) Targets
: All members of the House of Representatives who have not
cosponsored Mental Health Parity legislation this year. If
you click on the link to H.R.
1402, you can view the list of cosponsors to date.
Message : “I am calling to ask the Representative
to [again] cosponsor H.R.
1402, the Paul Wellstone Mental Health Equitable Treatment
Act. Parity is a fair and affordable solution that will save
lives and families.”
The Issue at Hand
Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN)
have reintroduced, “The Paul Wellstone Mental Health
Equitable Treatment Act,” H.R. 1402. With one difference,
this bill is identical to their parity bill from 2003, H.R.
953, which gained the cosponsorship of a record 249 Members
of the House. That number included an all-time high 46 House
Republicans. As 229 of the 249 previous cosponsors returned
to the House, we have a large base of support that must be
recontacted and asked for cosponsorship anew.
The difference in the new legislation is that it no longer
specifically excludes substance abuse services from parity
protection. This is fair and appropriate in light of new data
showing that parity in the Federal Employee Health Benefit
Program has had minimal cost. Members of Congress and their
staffs are among the 8.5 million federal employees, retirees
and dependents who have had parity for BOTH mental health and
substance use disorders since January 2001. The Paul Wellstone
Mental Health Equitable Treatment Act was modeled on that federal
employee benefit.
House Outlook : We’re pleased that 192 Members of the
House have already added their names as cosponsors of H.R.
1402. These Members should be thanked. As before, we want
to get as many Republicans as possible to cosponsor the bill,
demonstrating the bipartisan nature of this issue.
Senate Outlook : Senators Pete Domenici (R-NM) and Edward
Kennedy (D-MA) are waiting to introduce parity in the Senate
while they discuss the legislation with the new chairman of
the Health Committee, Sen. Mike Enzi (R-WY). They are encouraged
by the Chairman’s receptivity to the issue and hope that
they can gain his support for parity legislation prior to its
introduction. That may be instrumental in preventing parity
from being blocked by parity opponents in the Senate, no matter
how outnumbered they are. The Domenici/Kennedy bill last Congress
had 70 cosponsors in the Senate.
Background
The Paul Wellstone Mental Health Equitable Treatment Act
expands the Mental Health Parity Act of 1996 by prohibiting
group health plans from imposing treatment or financial limitations
on mental health benefits that are different from those applied
to medical/surgical services. The legislation closes the loopholes
that allow discrimination in the copayment, coinsurance, deductible,
maximum out-of-pocket limit and day and visit limits. It applies
only to group health plans already providing mental health
benefits, and excludes (as does current law) health plans sponsored
by employers of fewer than 50 people.
Highlights of the Equitable Treatment
Act of 2005(H.R. 1402)
Introduced
by Reps. Patrick Kennedy and Jim Ramstad
Equal Coverage for All Mental Disorders
- Expands the Mental Health Parity Act of 1996 (MHPA) to
prohibit a covered group health plan from imposing treatment
limitations or financial requirements on mental health and
chemical dependency treatment benefits that differ from limitations
on medical and surgical benefits.
- The bill only applies
to group health plans that opt to provide mental health
benefits and is modeled after the mental health benefits
provided through the Federal Employees Health Benefits Program
(FEHBP).
- Provides full parity for mental health conditions
listed in the latest version of the Diagnostic and Statistical
Manual of Mental Disorders, the industry standard
diagnostic manual used by Medicare, Medicaid, the FEHBP,
the FDA, the legal system and 13 states’ parity laws.
Requirements and Exemptions
- Coverage is contingent on the diagnosis being included
in an authorized treatment plan that is in accordance with
standard protocols and meets medical necessity criteria.
- There is a small business exemption for companies with
50 or fewer employees.
Cost
- A new study of the FEHBP program has shown that access
to care improved and costs were negligible.
- Research shows
that better mental health care results in savings to businesses
in the form of lower absenteeism and higher productivity.
According to the World Health Organization over one-fifth
of lost days of productivity are the result of mental and
addictive disorders.
- Every credible study of states experiences
with mental health parity have shown that mental health
costs rise minimally or fall after the implementation of
parity, as people have greater access to less expensive forms
of treatment.
The Need for Parity
- The Surgeon General has estimated that roughly 20 percent
of the U.S. population has a diagnosable mental disorder
in any given year, but only one in three receives treatment.
- Untreated depression costs American businesses $70 billion
each year in lost productivity and worker absenteeism according
to the Wall Street Journal. NIMH has found the U.S. loses
$180 billion per year due to all mental illness.
- The GAO
reports that 87 percent of health plans routinely force
patients to pay more for mental health care than other health
care and place stricter limits on mental health treatment
than on other health treatment, or both.
- For more information,
contact Jim Finley, NASW Government Relations Unit, at: jfinley@naswdc.org
|
About
NASW