Federal Parity Passed Unanimously by Senate Help Committee
Statement by NAMI Board President Jim McNulty
By a unanimous 21-0 vote today, the Senate Health, Education, Labor and Pensions (HELP) Committee favorably reported S 543, the Mental Health Equitable Treatment Act, out of committee and on to the full Senate. This action is a major step forward in the effort to enact a full federal parity bill before the 1996 Mental Health Parity Act expires on October 1, 2001. The next stop for S 543 is the full Senate, once Congress returns from its summer recess the week of September 3.
NAMI extends its thanks to the sponsors of S 543, Senators Pete Domenici (R-NM) and Paul Wellstone (D-MN) for their efforts in moving this important legislation forward. NAMI is also very grateful to several key members of the Senate HELP Committee - particularly Chairman Edward M. Kennedy (D-MA) and Senator Bill Frist (R-TN) - who played critical roles in negotiating an agreement that allowed for unanimous support from all senators on the Committee.
All NAMI members and advocates are encouraged to send a note of thanks to the members of the Senate HELP Committee for voting in favor of S 543 today and (more importantly) urge them to support parity legislation when it goes to the full Senate in September. Please express your appreciation for their support of legislation to end arbitrary and discriminatory caps on insurance benefits for the treatment of severe mental illnesses.
Members of the Senate HELP Committee (*Cosponsors of S 543)
*Edward M. Kennedy, Mass. - Chairman - 202-224-4543 Fax 202-224-2417
*Christopher J. Dodd, Conn. - 202-224-2823; Fax 202-224-1083
*Tom Harkin, Iowa - 202-224-3254/Fax 202-224-9369
*Barbara A. Mikulski, Md. - 202-224-4654; Fax 202-224-8858
*Jeff Bingaman, N.M. - 202-224-5521; Fax 202-224-2852
*Paul Wellstone, Minn. - 202-224-5641; Fax 202-224-8438
*Patty Murray, Wash. - 202-224-2621; Fax 202-224-0238
*Jack Reed, R.I. - 202-224-4642; Fax 202-224-4680
*John Edwards, NC - 202-224-3154; Fax 202-228-1374
*Hillary Rodham Clinton, NY - 202-224-4451; Fax 202-228-0282
*James Jeffords, Vermont - 202-224-5141; Fax 202-228-0776
Judd Gregg, NH - Ranking Member - 202-224-3324; Fax 202-224-4952
Bill Frist, Tenn. - 202-224-3344; Fax 202-228-1264
Michael B. Enzi, Wyo. - 202-224-3424; Fax 202-228-0359
Tim Hutchinson, Ark. - 202-224-2353; Fax 202-228-3973
*John Warner, VA - 202-224-2023; Fax 202-224-6295
Christopher Bond, MO - 202-224-5721; Fax 202-224-8149
*Pat Roberts, Kan. - 202-224-4774; Fax 202-224-3514
*Susan Collins, Maine 202-224-2523; Fax 202-224-2693
Jeff Sessions, Ala. - 202-224-4124; Fax 202-224-3149
*Mike DeWine, Ohio - 202-224-2315; Fax 202-224-6519
In addition, NAMI members are urged to contact Senate Majority Leader Tom Daschle (D-SD) and Minority Leader Trent Lott (R-MS) and ask them to bring forward S 543 to the full Senate as early as possible in September. Remind them that the October 1 sunset of the 1996 Mental Health Parity Act is looming and that the Senate needs to take immediate action to end insurance discrimination and make full parity a reality for consumers and families living with mental illness.
Senate Majority Leader Tom Daschle, SD - 202-224-2321; Fax 202-224-7895
Senate Minority Leader Trent Lott, MS - 202-224-6253; Fax 202-224-2262
Modifications to S 543
During the HELP Committee "mark-up" hearing this morning, nearly all of the major components of S 543 stayed intact, including protections that prohibit health plans from imposing restrictions, conditions and enrollee cost sharing requirements on mental illness treatment that do not apply to all other medical treatment. This protection is central to the principle underlying parity, that mental illnesses are brain disorders and that there is no medical justification to cover treatment on different terms and conditions. Unlike the 1996 federal law that covered parity for annual and lifetime dollar limits only, S 543 would extend parity to limits on inpatient days and outpatient visits, as well as deductibles and co-payments for office visits and prescriptions.
In moving toward a bipartisan agreement on S 543, members of the HELP Committee made several modifications to the bill designed to address the concerns of employers and health plans. Foremost among these was increasing the number of small businesses that would be exempt from the law. The original version of S 543 exempted employers with 2 to 25 workers (S 543 does not apply to the individual insurance market). The bill reported by the HELP Committee today increases that exemption to firms with 2 to 50 employees.
In addition, members of the HELP Committee made several technical changes to the bill designed to ensure that employers and health plans can manage benefits and make certain that treatment services are medically necessary, clinically appropriate and part of an authorized treatment plan. In addition, language was added to S 543 to make the scope of parity consistent with the parity standard now in the Federal Employee Health Benefits Program (FEHBP) - the model upon which S 543 is based. Specifically, the new language clarifies that the parity requirement is restricted to providers that are in a health plan's network (if a health plan has a restricted network of providers). Finally, since S 543 does not require parity for substance abuse treatment, senators added language clarifying that chemical dependency diagnoses in the APA's DSM IV listings (the definition cited in the legislation) are not covered.
Several members of the HELP Committee - including Senator Judd Gregg (R-NH) - expressed interest in offering an amendment that would create an exemption to the law in case costs associated with implementing parity resulted in employers dropping coverage. A similar provision exists in the 1996 Mental Health Parity Act. A preliminary estimate form the Congressional Budget Office (CBO) projects that insurance premiums will rise only 1% as a result of S 543. Senator Gregg declined to offer this cost increase exemption amendment, but reserved the right to offer it when the bill reaches the full Senate.
Cosponsors Continue to Sign on to S 543
Since NAMI's last report on the NAMI E-News (Vol. 02-2, July 24, 2001), 5 additional senators have become cosponsors of S 543 bringing the total to 51. The new cosponsors include: Tom Carper (D-DE), Mark Dayton (D-MN), Mike DeWine (R-OH), Diane Feinstein (D-CA), and Olympia Snowe (R-ME). It is still important for NAMI members to contact their senators that have yet to sign on to the bill. For a complete list of current cosponsors of S 543, go to http://www.nami.org/update/20010406.html scroll down to the bottom of the document and click on "Cosponsors."
Statement by Jim McNulty,
NAMI Board President
Today's action by the Senate Committee on Health, Employment, Labor & Pensions (HELP), recommending S.543, the Mental Health Equitable Treatment Act of 2001 unanimously to the full Senate represents an important step forward to strengthen existing law and end discrimination in insurance coverage.
It is a victory for children and adults with mental illnesses. It is a victory for employers whose overall productivity is adversely affected by untreated mental illness. It is a victory for bipartisanship in the nation's capital.
NAMI is grateful to Senator Ted Kennedy (D-MA), chairman of the committee, as well as the ranking minority member, Senator Judd Gregg (R-NH) and Senator Bill Frist (R-TN), who have taken an interest in the legislation. We are especially grateful for the leadership of Senators Pete Domenici (R-NM) and Paul Wellstone (D-MN) in sponsoring the bill, as well as that of the 49 other Senators who are co-sponsors.
Let one fact be clear: a clear majority of the United States Senate today is supporting the legislation. If the bill becomes law, it will cover the full range of mental illnesses, including major depression, bipolar disorder (manic-depression), schizophrenia, and anxiety disorders, and will strengthen the 1996 law by prohibiting unequal limits on annual or lifetime mental health benefits, inpatient hospital days, outpatient visits, and out-of-pocket expenses.
I congratulate NAMI members whose grassroots education and contacts with lawmakers made today's committee action possible. During the weeks since NAMI's national convention earlier this month, nearly ten Senators have joined in co-sponsoring S.543. They include Democrats and Republicans. With one out of every five Americans affected by mental illness in some way, this legislation touches all of us. It will help individuals and families. It will help people get treatment when they need it and preserve hope for recoveries.