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November 7, 2001

Final Push Needed For Federal Parity
6 Steps Every NAMI Advocate Can Take to Ensure Victory

The struggle for federal parity legislation is moving toward a critical stage as members of the House-Senate Conference Committee on the FY 2002 Labor-HHS-Education Appropriations bill (HR 3061) prepare to meet. This Conference Committee, made up of two dozens senators and members of Congress, will be deciding whether or not to include full mental illness insurance parity legislation (S 543) in the final version of the bill that will be sent to the White House for President Bush's signature. Since the Conference Committee is expected to finish its work within the next 10 days to two weeks, time is of the essence for consumers and family members to deliver their message to Congress and the President.

Every Member of Congress is Important

Even though only two dozen members of Congress are on the Conference Committee on the Labor-HHS-Education Appropriations bill (HR 3061), every House member and senator is in a position to influence the outcome of the Senate parity amendment. House members not on the Conference Committee have the opportunity to advocate for parity on your behalf. They can do this by contacting both the leadership (Speaker Dennis Hastert, Majority Leader Dick Armey and Minority Leader Richard Gephardt) and the leaders of the Appropriations Committee (Chairman C.W. "Bill" Young, Subcommittee Chairman Ralph Regula and Ranking Minority Member David Obey). Likewise, all senators can influence the Conference Committee by contacting the leadership (Majority Leader Tom Daschle and Minority Leader Trent Lott) and leaders of the Appropriations Committee (Chairman Robert Byrd, Ranking Member Ted Stevens, Subcommittee Chairman Tom Harkin and Subcommittee Ranking Member Arlen Specter).

Members of the House Conference Committee on the Labor-HHS-Education Appropriations Bill (HR 3061)

As noted in previous NAMI E-News messages, the following members will be serving on the Conference Committee:

House: Randy "Duke" Cunningham (R-Escondido, CA), Rosa DeLauro (D-New Haven, CT), Kay Granger (R-Ft. Worth, TX), Steny Hoyer (D-Greenbelt/Waldorf, MD), Ernest Istook (R-Oklahoma City, OK), Jesse Jackson, Jr. (D-Chicago/Homewood, IL), Patrick Kennedy (D-Woonsocket/Newport, RI), Nita Lowey, (D-White Plains, NY), Dan Miller (R-Sarasota/Bradenton, FL), Anne M. Northup (R-Louisville, KY), David Obey (D-Superior/Wausau, WI), Nancy Pelosi (D-San Francisco, CA), John Peterson (R-State College, PA), Ralph Regula (R-Canton, OH), Don Sherwood (R-Scranton, PA), Roger Wicker (R-Tupelo, MS) and C.W. "Bill" Young (R-St. Petersburg, FL).

Senate: Robert Byrd (D-WV), Thad Cochran (R-MS), Larry Craig (R-ID), Mike DeWine (R-OH), Judd Gregg (R-NH), Tom Harkin (D-IA), Ernest Hollings (D-SC), Kay Bailey Hutchison (R-TX), Daniel Inouye (D-HI), Herb Kohl (D-WI), Mary Landrieu (D-LA), Patty Murray (D-WA), Harry Reid (D-NV), Arlen Specter (R-PA) and Ted Stevens (R-AK).

NAMI advocates in the states and congressional districts of these members of Congress are particularly urged to write and call in support of the Senate mental illness parity amendment.

6 Things Every NAMI Advocate Can Do To Help Ensure Passage of Parity in 2001

1. Write and call your senators and House member
   This is the most direct and important means of lobbying your members of Congress. NAMI and its colleague advocacy organizations have set up a toll-free parity legislative hotline at 1-866-PARITY4 (1-866-727-4894) to reach the Capitol Switchboard and ask for your Representative's office by name or by giving your home ZIP code. Once connected, NAMI advocates should ask to speak to the member's Health Legislative Assistant and urge them to support the Domenici-Wellstone mental illness parity amendment to the Labor-HHS-Education Appropriations bill (HR 3061)- include urging the member of Congress to weigh in with the leaders of the House-Senate Conference Committee.

   Below is a sample letter that advocates are encouraged to adapt and use. It is important to note that because of the discovery of anthrax in several congressional office buildings, U.S. mail is not currently being accepted in members' Washington, DC offices. However, mail is being accepted in state and district offices - local addresses are available through each member of Congress's Web site (links available at www.house.gov) and in the Blue Pages of local phone books. In addition, members offices are accepting e-mail messages (note - when sending e-mail, make sure to include your street address so that the member's staff understands that you are a constituent). This information is also available through the "Write to Congress" link on the NAMI Policy website at www.nami.org/policy.htm.

2. Meet with your House member directly
   Tomorrow, the House and Senate will both be out of session for the Veterans' Day weekend, not returning until November 13. Most senators and House members will be in their home states and districts meeting with constituents and attending Veterans' Day events. For many, this will include appearances at public forums, radio call-in programs and events sponsored by veterans groups (e.g., VFW and American Legion posts). These are important opportunities for NAMI members to directly urge members of Congress to support parity.
   *Note - it is extremely important when attending events associated with Veterans' Day for NAMI advocates to be respectful of the tone and purpose of this holiday which is honoring those that have worn the uniform to protect our country's freedom. NAMI advocates are also encouraged to contact local district and state congressional offices to request a direct meeting with your member of Congress.

3. Contact President Bush
   In order for parity to become law in 2001, it must be signed by President Bush. As the underlying Labor-HHS-Education bill is considered by the Conference Committee, the President will play an important role in shaping the final legislative product. Thus, it is critically important for the White House to hear from NAMI advocates in support of the Domenici-Wellstone amendment. U.S. mail delivery to the White House has been complicated by the recent discovery of anthrax in a sorting facility. Thus, advocates are encouraged to deliver their message through the White House comment line (202-456-1414) or by e-mail through the White House Web site: www.whitehouse.gov/contact. Please remind President Bush that he is already on record in support non-discriminatory coverage - he signed a mental illness parity bill in 1997 as Governor of Texas (due in large part through the advocacy of NAMI Texas).

4. Write a letter to the editor or guest op-ed
   Every member of Congress reads his or her local newspapers - and is always attentive to any letter to the editor or opinion piece that directly mentions their name or any federal legislative issues. Letters to the editor can be particularly effective in that they reach a far wider audience. A sample guest editorial (that is easily adaptable as a letter to the editor) is included below.

5. Organize a meeting with your editorial board
   Even more powerful than a letter to the editor of a daily newspaper is the editorial opinion of the newspaper itself. Most newspapers have editorial boards that make themselves available for meetings to solicit the opinions of the community. These meetings can result in a highly credible editorial being printed in the newspaper in support of parity. Likewise, many local radio and television stations operate similar editorial boards and opportunities for community input. Meetings with these editorial boards can usually be scheduled by contacting the office of the editorial page editor of your local newspaper. However, given the short timeline for action on parity legislation this year, it is critically important to request an editorial board meeting ASAP. Written materials needed to make the case for insurance parity are available through the parity Media Kit on the NAMI website at: http://www.nami.org/pressroom/index.html

6. "Grass-tops" lobbying
   While the opinion of every constituent is supposed to be equal in the eyes of members of Congress, they rarely are. For every member of Congress, there are always certain community leaders and elected officials whose opinions carry more weight, either through stature, experience, or most often, personal relationships. Seeking out these community leaders and urging them to add their voice of support to NAMI's is commonly referred to "grass-tops" lobbying. The most effective targets for this type of lobbying are community leaders that have some connection to your local NAMI affiliate - civic and business leaders, clergy, police officials, school board members, etc. Perhaps the most effective "grass-tops" lobbying efforts occur with current and former elected officials (state legislators, mayors, city council members, county officials, etc.) that are willing to come forward and support parity. This is especially the case when these current and former elected officials are of the same political party as your senators or House member. Likewise, individuals who serve on state Democratic and Republican Committees (of the same political party as your member of Congress) can be an effective voice. NAMI advocates are encouraged to seek out these targets and urge them to join in the fight for passage of parity in 2001.

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SAMPLE CONGRESSIONAL LETTER

Dear Senator/Representative:

I am writing to urge your support for the Wellstone-Domenici mental illness insurance parity amendment to the Labor-HHS Appropriations bill (HR 3061). As an individual living with mental illness/a family member of an individual living with mental illness, I strongly support this bipartisan effort to end insurance discrimination against mental illness treatment.

[add a brief, personal anecdote about your own experience with insurance discrimination or struggle to access coverage for treatment]

On October 30, the Senate attached mental illness parity legislation to HR 3061 by a unanimous vote. This important measure is based on the Mental Health Equitable Treatment Act (S 543), legislation that would expand the recently expired 1996 Mental Health Parity Act to full parity for mental illness treatment. S 543 has 65 Senate cosponsors and was favorably reported by the Health, Education, Labor and Pensions (HELP) Committee on August 1 by a 21-0 vote. This important legislation would prevent health plans from imposing terms and conditions on coverage for mental illness treatment that do not apply to all other diseases. As such, it is not a mandate of health insurance, but rather a coverage condition that simply calls for plans to put in place equitable treatment limitations and cost sharing requirements for all illnesses.

As Congress and the House-Senate Conference Committee on the Labor-HHS-Education Appropriations bill moves towards a vote on this landmark legislation, please remember that:

• mental illnesses such as schizophrenia, bipolar disorder, major depression, obsessive-compulsive disorder and severe anxiety disorders are real illnesses,
• treatment for mental illness works - with efficacy rates for most severe mental illnesses exceed those for heart disease and diabetes,
• there is simply no scientific or medical justification for insurance coverage of mental illness treatment to be on different terms and conditions than other diseases,
• discriminatory insurance coverage of mental illness bankrupts families and places a tremendous burden on taxpayers,
• parity is affordable - the Congressional Budget Office (CBO) estimates that S 543 will increase insurance premiums only .9% (a finding that is consistent with numerous previous studies that demonstrate how non-discriminatory coverage is economical and results in better treatment outcomes),
• 34 states have enacted parity laws similar to S 543, but even these laws offer no protection for workers and their families that receive coverage through self-insured ERISA plans, and
• any alternative to merely renew the 1996 Mental Health Parity Act would wipe out an important opportunity to end insurance discrimination against people with mental illnesses once and for all.

Thank you for your attention on this important issue. Please support mental illness parity and urge your colleagues on the House-Senate Conference Committee on HR 3061 to do the same.

Sincerely,

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SAMPLE LETTER TO THE EDITOR OR GUEST EDITORIAL

What's Wrong With This Picture?
When one is diagnosed with heart disease or diabetes, we expect our health plan to cover the treatment needed. That is why we have health insurance coverage - to pay for the treatment we hope we never need. Health insurers usually do the right thing and cover the treatment that is needed for almost every organ of the body - except the brain.

For many families living with mental illness, diseases of the brain, adequate insurance coverage is elusive. Typically, health plans offer minimal coverage for illnesses of the brain such as schizophrenia, bipolar disorder and major depression. They often include strict limits on inpatient days and outpatient visits. These restrictions do not apply to illnesses like cancer, heart disease and diabetes. In addition, most health plans require higher copayments and deductibles that apply only to mental illness treatment.

In my view, this is discrimination plain and simple. This type of insurance discrimination is particularly unfair given recent advances in scientific research that a) demonstrate the biological basis of diseases such as schizophrenia, bipolar disorder and major depression and b) that have resulted in the development of new treatments that are incredibly effective in addressing symptoms and restoring function. More importantly, insurance discrimination can lead to financial ruin for many families and result in a tremendous burden being shifted to taxpayers in the form of disability benefits and the costs associated with untreated mental illness (emergency room visits, homelessness, etc.).

Unfortunately, I know insurance discrimination first-hand. As an individual living with mental illness/family member of an individual living with mental illness, I have experienced what it is like to run up against unfair and arbitrary limits in coverage. [insert brief personal story].

What can be done about insurance discrimination against individuals with mental illness? Senators Pete Domenici (R-NM) and Paul Wellstone (D-MN) have developed a proposal that would require health plans to cover treatment for mental illness on the same terms and conditions as all other diseases. This "parity" proposal has passed the Senate and is now before a joint House-Senate committee that will soon determine whether or not it becomes law in 2001. Congressman/Congresswoman/Senator __________ should join Senators Domenici and Wellstone in supporting this measure in order to bring an end to insurance discrimination once and for all. The people of _________ County and the nation are counting on Congressman/Congresswoman/Senator ____________ to support passage of mental illness parity this year.  

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