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February 28, 2003

Paul Wellstone Mental Health Equitable Treatment Act of 2003 Introduced

Senators Domenici & Kennedy and Representatives Ramstad & Kennedy Introduce New Mental Illness Parity Bill
Measure Named in Honor of the Late Senator Paul Wellstone


Vowing to finish the job and pass legislation this year, a bipartisan group of Senate and House members introduced a new mental illness insurance parity bill yesterday.  The bill, which will be known as the Paul Wellstone Mental Health Equitable Treatment Act of 2003 (S 486/HR 953), has already garnered support from 24 Senators and 162 House members that have signed on as cosponsors. 

At a press conference yesterday on Capitol Hill, the four lead sponsors Senators Pete Domenici (R-NM) and Edward M. Kennedy(D-MA) and Representatives Jim Ramstad (R-MN) and Patrick Kennedy (D-RI) pledged to push for quick action in 2003 to get the bill to the President?s desk by year's end.  Each of these congressional leaders invoked the memory of the late Senator, and parity champion, Paul Wellstone of Minnesota in calling on allies in and outside of Congress to work hard to get S 486/HR 953 through Congress this year.  Also participating in the press conference was NAMI member Peg Nichols of Washington, DC who told of her family's struggle to access and pay for treatment for her two son's diagnosed bipolar disorder.   

President Bush has already voiced support for federal parity legislation, and in recent weeks Senator Domenici has been pressing for increased presidential pressure for action on the part of the House of Representatives.  It is likely that the action in the House on parity will prove critical in 2003.  Support for parity has always been stronger in the Senate and both Senators Domenici & Kennedy are already working with Majority Leader Bill Frist (R-TN) and Health, Education, Labor and Pensions (HELP) Committee Chairman Judd Gregg (R-NH) to bring the parity bill forward this spring.


ACTION REQUIRED



In order to ensure swift action on the part of both the House and Senate, the sponsors of the Paul Wellstone Mental Health Equitable Treatment Act are asking NAMI members to help press for additional cosponsors for their legislation.  All NAMI advocates are urged to call members of the congressional delegation to urge them to cosponsor S 486/HR 953.  When calling Senators and House members, NAMI advocates should remind their elected representatives that:

  • President Bush supports efforts in Congress to pass a federal parity bill and on April 29, 2002 declared Senator Domenici and I share this commitment: health plans should not be allowed to apply unfair treatment limitations or financial requirements on mental health benefits.  It is critical that we provide full mental health parity and that we do not significantly run up the cost of health care,
  • untreated mental illness costs American businesses, government and families at least $79 billion annually in lost productivity and unemployment, broken lives and broken families, emergency room visits, homelessness and unnecessary use of jails and prisons,
  • mental illnesses such as schizophrenia, bipolar disorder, major depression, obsessive-compulsive disorder and severe anxiety disorders are real illnesses,
  • treatment for mental illness works, if you can get it treatment 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 through suicide, homelessness and inappropriate 'criminalization' of mental illness,
  • parity is affordable for employers and health plans the Congressional Budget Office estimates that this legislation will result in premium increases of only .9% -- costs that are far outweighed by lower absenteeism and higher productivity when mental illness is treated earlier, and
  • 34 states have enacted parity laws similar to S 486/HR 953, but even these laws offer no protection for workers and their families that receive coverage through self-insured ERISA plans.

    All members of Congress can be reached by calling the Capitol Switchboard toll free at 1-800-839-5276 or at 202-224-3121 or online through www.congress.org



Is Your Member of Congress Already a Cosponsor of S 486/HR 953?



As noted above, 25 Senators and 162 House members are already on record in support of the Paul Wellstone Mental Health Equitable Treatment Act of 2003.  If either of your Senators or House members are among these cosponsors, you are urged to contact their office to express thanks for their support for non-discriminatory coverage for mental illness treatment.    

Senate Cosponsors of S 486: Coleman (R-MN), Dayton (D-MN), Grassley (R-IA), Reed
(D-RI), Cochran (R-MS), Dodd (D-CT), Warner (R-VA), Reid (D-NV), Thomas (R-WY),
Johnson (D-SD), Specter (R-PA), Harkin (D-IA), Lugar (R-IN), Daschle (D-SD),
Graham (R-SC), Murray (D-WA), Collins (R-ME), Cantwell (D-WA), Roberts (R-KS),
Edwards (D-NC), Chafee (R-RI), Lincoln (D-AR) and Bennett (R-UT). 

House Cosponsors of HR 953:  Abercrombie (D-HI), Ackerman (D-NY), Allen (D-ME),
Andrews (D-NJ), Baca (D-CA), Baird (D-WA), Balance (D-NC), Becerra (D-CA),
Berkley (D-NV), Berman (D-CA), Berry (D-AR), Bishop (D-NY), Blumenauer (D-OR),
Boehlert (R-NY), Bordallo (D-GU), Boucher (D-VA), Brady (D-PA), Brown (D-FL),
Brown (D-OH), Burns (R-GA), Capps (D-CA), Capuano (D-MA), Cardin (D-MD), Carson
(D-OK), Carson (D-IN), Case (D-HI), Christensen (D-VI), Clyburn (D-SC), Conyers
(D-MI), Cooper (D-TN), Costello (D-IL), Davis (D-IL), Davis (D-FL), Davis (D-TN),
Davis (D-CA), DeFazio (D-OR), DeGette (D-CO), Delahunt (D-MA), DeLauro (D-CT),
Deutsch (D-FL), Dicks (D-WA), Dingell (D-MI), Doggett (D-TX), Doyle (D-PA),
Emanuel (D-IL), Engel (D-NY), English (R-PA), Etheridge (D-NC), Faleomavaega
(D-AS), Farr (D-CA), Fattah (D-PA), Foley (R-FL), Ford (D-TN), Frelinghuysen
(R-NJ), Frost (D-TX), Gilchrest (R-MD), Green (D-TX), Greenwood (R-PA), Grijalva
(D-AZ), Gutierrez (D-IL), Hinchey (D-NY), Hoeffel (D-PA), Holden (D-PA), Holt
(D-NJ), Honda (D-CA), Hooley (D-OR), Inslee (D-WA), Jackson-Lee (D-TX),
Tubbs-Jones (D-OH), Kelly (R-NY), Kildee (D-MI), Kilpatrick (D-MI), Kind (D-WI),
Kirk (R-IL), Kleczka (D-WI), Kucinich (D-OH), Langevin (D-RI), Larsen (D-WA),
Larson (D-CT), LaTourette (R-OH), Leach (R-IA), Lee (D-CA), Levin (D-MI),
Lipinski (D-IL), LoBiondo (R-NJ), Lowey (D-NY), Maloney (D-NY), Matheson (D-UT),
Matsui (D-CA), McCarthy (D-NY), McCollum (D-MN), McDermott (D-WA), McGovern
(D-MA), McHugh (R-NY), McNulty (D-NY), Meehan (D-MA), Menendez (D-NJ), Miller
(R-CA), Miller (D-CA), Mollohan (D-WV), Moran (D-VA), Murphy (R-PA), Murtha
(D-PA), Nadler (D-NY), Napolitano (D-CA), Norton (D-DC), Norwood (R-GA), Oberstar
(D-MN), Olver (D-MA), Ortiz (D-TX), Owens (D-NY), Pallone (D-NJ), Pascrell
(D-NJ), Pastor (D-AZ), Payne (D-NJ), Pelosi (D-CA), Peterson (D-MN), Platts
(R-PA), Price (D-NC), Quinn (R-NY), Rahall (D-WV), Rangel (D-NY), Rodriguez
(D-TX), Rothman (D-NJ), Roybal-Allard (D-CA), Ryan (D-OH), Sabo (D-MN), Sanchez
(D-CA), Sanders (I-VT), Saxton (R-NJ), Schakowsky (D-IL), Schiff (D-CA), Scott
(D-VA), Serrano (D-NY), Shays (R-CT), Simmons (R-CT), Skelton (D-MO), Slaughter
(D-NY), Smith (R-NJ), Snyder (D-AR), Solis (D-CA), Stark (D-CA), Strickland
(D-OH), Stupak (D-MI), Sweeney (R-NY), Tauscher (D-CA), Thompson (D-CA), Tierney
(D-MA), Towns (D-NY), Udall (D-NM), Van Hollen (D-MD), Visclosky (D-IN), Walsh
(R-NY), Wamp (R-TN), Watson (D-CA), Waxman (D-CA), Weiner (D-NY), Wilson (R-SC),
Woolsey (D-CA) and Wynn (D-MD). 


Details of the Senator Paul Wellstone Mental Health Equitable Treatment Act of
2003



S 486/HR 953 is nearly identical to the same bill that was unanimously approved by the Senate HELP Committee in August 2001.  This bill was later attached by the full Senate to an unrelated spending bill that the House rejected in December 2001.  As with all other parity measures that NAMI has been pursuing for more than a decade, the bill is centered on a requirement for health insurance policies to cover treatment for mental illnesses on the same terms and conditions as all other illnesses. 

Beyond this basic equal coverage requirement, S 486/HR 953:

  • ties parity to standards in the Federal Employees Health Benefits Program (FEHBP) that most members of Congress and that staffs participate in,
  • expands the Mental Health Parity Act of 1996 (MHPA) to prohibit group health plans from imposing treatment limitations or financial requirements on the coverage of mental health benefits unless comparable limitations are imposed on medical and surgical benefits,
  • requires parity for all categories of mental disorders, including schizophrenia, bipolar disorder, major depression, obsessive-compulsive disorder, and severe anxiety disorders,
  • restricts parity to coverage to providers in a health plan's network and treatment that is consistent with an authorized treatment plan and in accordance with standard protocols and the treatment plan meets medical necessity determination criteria,
  • allows health plans to use standard management tools (utilization review, prior authorization, etc.) make parity coverage affordable for employers,
  • defines "treatment limitations" as limits on the frequency of treatment, the number of visits, the number of covered hospital days, or other limits on the scope and duration of treatment and defines "financial requirements" to include deductibles, coinsurance, co-payments, and catastrophic maximums,
  • eliminates the current December 31, 2003 sunset provision in the MHPA, and
  • contains a small business exemption for firms with 50 or fewer workers.

Finally, included below is the statement of NAMI President Jim McNulty in support of S 486/HR 953.



NAMI URGES SUPPORT FOR THE PAUL WELLSTONE MENTAL HEALTH EQUITABLE TREATMENT ACT
Federal Legislation Is A Vital Step in Ending Insurance Discrimination



Statement by Jim McNulty, President
National Alliance for the Mentally Ill (NAMI)

The National Alliance for the Mentally Ill (NAMI) fully supports the Paul Wellstone Mental Health Equitable Treatment Act of 2003.  We are grateful for the leadership of Senators Pete Domenici (R-NM) and Edward M. Kennedy (D-MA) and Representatives Jim Ramstad (R-MN) and Patrick Kennedy (D-RI) in seeking to end discriminatory health insurance coverage for children and adults with severe mental illnesses and their families.

NAMI is especially pleased that these distinguished legislators have dedicated this important federal legislation to the legacy of the late Senator Paul Wellstone of Minnesota.  Paul Wellstone dedicated much of this career in public service toward ending discrimination against children and adults living with mental illness.  As a family member of someone living with mental illness, Senator Wellstone knew from personal experience how insurance discrimination can lead directly to financial devastation for families and the many tragedies associated with lack of access to mental illness treatment:  suicide, broken families, homelessness, substance abuse and interaction with the criminal justice system. 

Paul Wellstone established a record of accomplishment on behalf of people with mental illness that is nearly unrivaled in the United States Senate.  It is fitting that this new version of the mental illness insurance parity is being named after him and his lifelong goal of ensuring that treatment for illnesses such as schizophrenia, bipolar disorder, major depression and severe anxiety disorders are covered on the same terms and conditions as all other diseases.     
    
This legislation will strengthen current federal law and finish the work that Congress began seven years ago with the Mental Health Parity Act of 1996.  It is the same legislation that passed the Senate in October 2001, only to be blocked in the House of Representatives later that year.  It will extend to most Americans the equitable coverage of mental illnesses already available to federal employees and to Members of Congress under the Federal Employees Health Benefit Plan (FEHBP) program.

The Paul Wellstone Mental Health Equitable Treatment Act of 2003 is consistent with the goal articulated by President Bush in April 2002 that there is no scientific justification for health insurance plans to cover the treatment of mental illnesses on different terms and conditions from physical illnesses.  With its enactment, families across the United States will have more equitable access to effective treatments that are essential to recovery.

The Paul Wellstone Mental Health Equitable Treatment Act of 2003 will require all health insurance plans to meet the standards set by the FEHBP, ending discriminatory treatment limitations and financial requirements. It would cover the full range of mental illnesses, including schizophrenia, bipolar disorder (manic depression), major depression, obsessive-compulsive and panic disorders, and serious childhood mental illnesses, among others. This legislation will strengthen the 1996 law by prohibiting unequal restrictions on annual or lifetime mental health benefits, inpatient hospital days, outpatient visits, and out-of-pocket expenses.

The approach is similar to that recently taken by many states. Today the majority of Americans live in states that have parity laws 34 states currently have such laws, with others likely to follow in 2003.  But federal legislation is needed as well, in part because the federal ERISA law has allowed self-insured plans to escape state parity requirements. 

The total cost of parity is low, because the removal of discriminatory limits is replaced with processes for assessing the medical necessity of proposed treatments. Parity is both affordable and cost-effective.  With parity coverage for the treatment of mental illnesses, businesses may also recapture some of the low cost through reduced absenteeism; reduced healthcare costs for physical ailments related to mental illnesses; increased employee morale; and increased overall productivity.

In April 2002, President Bush announced his support for parity legislation and while appointing his "New Freedom" Commission on Mental Health, and promised to work with Senate and House leaders to pass parity "this year."  In April 2003, the President's Commission will issue its final report and recommendations for an even broader reforms of the nation's mental healthcare system.  Parity is an essential first as part of those reforms. 

Too often in the past, political leaders have made been to help people with illnesses, only to be broken.  We already know how to treat people and support recovery.  The problem is that people cannot get the treatment they need when they need it. The Senate previously has passed this legislation.  Only a few leaders in the House of Representatives prevented it from becoming law two years ago.

NAMI calls on Congress to act now.  Please do not break President Bush's promise.  Do not neglect or abandon us.  The time to pass parity is now, for all Americans.


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