The Medicare Mental Health Modernization Act of 2001
Below are the statement of and letter from NAMI President Jackie Shannon in support of insurance parity for mental illness benefits in the Medicare program. NAMI is supporting two legislative proposals in Congress, the Medicare Mental Health Modernization Act of 2001 (House and Senate companion bills) and the Medicare Mental Illness Nondiscrimination Act of 2001 (House and Senate companion bills). The bill numbers and sponsors are:
Medicare Mental Health Modernization Act of 2001 –
Medicare Mental Illness Nondiscrimination Act of 2001 –
All NAMI members are encouraged to contact their Senators and Representative and urge them to cosponsor and support these important bills. All members of Congress can be reached by calling the Capitol Switchboard at 202-224-3121 or by clicking on "Write to Congress" on the NAMI website on the Public Policy home page, http://www.nami.org.
STATEMENT OF JACKIE SHANNON
NATIONAL ALLIANCE FOR THE MENTALLY ILL
IN SUPPORT OF
THE MEDICARE MENTAL HEALTH MODERNIZATION ACT OF 2001
April 4, 2001
On behalf of NAMI’s 210,000 members and 1,200 affiliates I pleased to offer our strong support for the Medicare Mental Health Modernization Act of 2001. As the nation’s largest organization representing individuals with severe illnesses and their families, NAMI is grateful to Senator Paul Wellstone (D-MN) and Representative Pete Stark (D-CA) for bringing this legislation forward.
NAMI has long been troubled by the Medicare program’s marked discrimination against individuals with mental illness. Medicare imposes conditions and limitations that no private health insurance would apply to mental illness treatment: no coverage for outpatient prescription drugs, a 50% co-payment requirement for outpatient services and 190-day lifetime limit on inpatient days. This is especially troubling to NAMI since the 50% co-payment and the 190-day lifetime limit on hospitalization apply only mental illness NOT to other medical conditions.
Medical science has demonstrated that mental illnesses such as schizophrenia, bipolar disorder and major depression are biologically-based brain disorders. The 1999 Surgeon General’s Report on Mental Health reiterated these scientific findings and declared that there is no justification for health plans to cover treatment for mental illness on different terms and conditions than other medical disorders. While considerable progress has been made in recent years to eliminate discrimination against mental illness treatment in the private health insurance market (e.g., the 1996 federal Domenici-Wellstone parity law, 33 state parity laws, parity in FEHBP), Medicare beneficiaries have been left behind.
NAMI strongly supports the Medicare Mental Health Modernization Act, including its provisions establishing parity for outpatient cost sharing and eliminating the discriminatory limit on inpatient treatment. NAMI also supports the bill’s provisions establishing new intensive residential and outpatient services such as programs of assertive community treatment (PACT), intensive case management and psychiatric rehabilitation. Research on mental illness treatment and services has advanced significantly since 1965, but tragically, Medicare has not. Modernization is long overdue and this legislation begins the process of getting the job done.
Efforts to reform Medicare too often focus only on the needs of elderly beneficiaries. While NAMI supports efforts to address the unmet treatment needs of older Americans, we also believe that Congress must address the impact of proposed changes on the 5 million non-elderly people with disabilities eligible for Medicare because they are receiving Social Security Disability Insurance cash benefits – 25% of whom became eligible for SSDI because of a mental illness.
In 1999, Congress passed Ticket to Work and Work Incentives Improvement (TWWIIA) to grant these beneficiaries an additional 6 years of Medicare eligibility when they go to work. NAMI is proud to support Representative Stark’s bill (HR 481) to make this extension permanent. In addition, removing the discrimination against Medicare coverage of mental illness will enhance the Ticket to Work initiative by extending better treatment coverage to people trying to return to productive work. Passage of the Medicare Mental Health Modernization Act will ensure that Medicare beneficiaries with severe mental illnesses are able to access non-discriminatory coverage that will allow them to work and reach their full potential.
NAMI is grateful for the leadership of Senator Wellstone and Representative Stark in bringing this legislation to end discrimination in the federal government’s largest health care program. NAMI calls on Congress to pass this bill to modernize Medicare and make the program consistent with mental illness treatment in the 21st century.
May 23, 2001
The Honorable Olympia Snowe
The Honorable John Kerry
United States Senate
Washington, DC 20510
Dear Senators Snowe and Kerry:
On behalf of NAMI’s 210,000 members and 1,200 affiliates I am writing to offer our strong support for the Medicare Mental Illness Nondiscrimination Act of 2001 (S 841). Thank you for bringing forward this important legislation to bring an end to discrimination in outpatient treatment services in the Medicare program. As the nation’s largest organization representing persons with severe mental illness and their families, we are extremely grateful for your leadership on this important issue.
Perhaps the most glaring shortcoming in the Medicare program is the discriminatory copayment for most outpatient mental illness treatment services. As you know, outpatient psychotherapy services are covered at 50 percent under Medicare, with a 50 percent beneficiary copayment requirement. This is stark contrast to the 80 percent payment, and 20 percent co-payment for all other outpatient services. In NAMI’s view, this is a clear form of discrimination in one of the federal government’s most important health care programs – providing coverage to more than 39 million Americans – both seniors and non-elderly people with severe disabilities such as serious mental illnesses. We know that treatment makes a tremendous difference in the lives of persons with mental illness. S 841 removes a significant financial barrier to such necessary care for the Medicare population.
Thank you for once again leading the way in Congress in bringing an end to discrimination against persons with living with severe mental illness.
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