Parity Advocates In Congress Vow To Pass Bill In 2003

The Senator Paul Wellstone Mental Health Equitable Treatment Act was introduced in Congress last month in honor of the late senator who was a passionate advocate for parity and mental health treatment. Wellstone died in a plane crash last October while on the campaign trail.

Sens. Pete Domenici (R-N.M.) and Edward Kennedy (D-Mass.), a ranking member of the Senate Health, Education, Labor, and Pensions Committee, joined with Reps. James Ramstad (R-Minn.) and Patrick Kennedy (D-R.I.) at a press briefing last month to announce their plan to get Congress to pass a parity bill this year.

The parity bills, which were introduced late last month, prohibit health plans from imposing greater restrictions on treatment and more severe financial requirements on patients with mental illness than they do for patients with other types of medical illness (see box on page 38).

The bills closely mirror the 2001 parity legislation that passed the Senate but stalled in House committees controlled by Republican leaders. Republican leaders had objected to “parity mandates” because of the belief that they would increase health care costs to employers above the Congressional Budget office estimate of less than 1 percent.

A majority of members in both chambers and more than 250 national organizations support the legislation, according to Rep. Kennedy. President George W. Bush announced his support for parity last spring (Psychiatric News, May 17, 2002). A survey by the National Mental Health Association (NMHA) last September showed that 79 percent of Americans favored parity legislation regardless of whether it increases their insurance premiums slightly, according to an NMHA press release.

“It is time for Congress to stop talking and start acting to end insurance discrimination against our patients,” said APA President Paul Appelbaum, M.D., in a press statement released on behalf of the APA-led Coalition for Fairness in Mental Illness Coverage. “This legislation makes the promise of full parity for persons with mental illness a reality. Study after study has shown that prompt, effective, medically necessary interventions to treat our patients save lives and money. . . . Insurance discrimination against persons with mental illness should be barred.”

The coalition members are the National Alliance for the Mentally Ill, National Mental Health Association, American Hospital Association, American Managed Behavioral Healthcare Association, American Medical Association, American Psychological Association, Federation of American Hospitals, and National Association of Psychiatric Health Systems.

Rep. Kennedy said at the press conference, “I could throw out a slew of statistics about the cost of mental illness to society, to businesses, but this isn’t about statistics—it’s about American families; it’s about lives wasted because the health care that can effectively treat people is put out of reach.”

Kitty Westin of Minnesota described at the press conference her daughter’s battle with anorexia nervosa, which lasted several months until her suicide in 2000 at age 21. Westin and her husband formed the Anna Westin Foundation to advocate for health insurance parity and better treatment on behalf of the approximately 8 million Americans with eating disorders. The Westins became friends with Wellstone after their daughter’s death.

“We believed that we had purchased the Cadillac of health insurance plans and that, in the event of illness, our family would have access to the best care available and as long as we needed it,” said Westin.

“Imagine our shock and anger when we discovered that our insurance company discriminated against people with mental illness. I will never forget the day we brought Anna to the emergency room. We were told by her treating physician that she was in critical condition—that her heartbeat was irregular, her liver was malfunctioning, her blood pressure was dangerously low, and her pulse was in the 30s.”

Yet, she was repeatedly denied the care her doctors recommended, said Westin. “We were outraged. We knew that if we had brought Anna to the emergency room with almost any other illness besides an eating disorder, she would have been admitted immediately and stayed there until she was ready to be released. Instead, Anna struggled and suffered. When the insurance company denied her treatment, Anna used that to further deny her condition and resisted life-saving treatment.”

She continued, “We were forced to guarantee payment for her treatment, which cost more than $1,600 per day. When Anna died, her sister told us that Anna had confided in her that she felt she was a financial burden on the family and that we would be better off if she died.”

Peg Nichols of Washington, D.C., described her family’s financial ordeal in caring for two sons diagnosed with bipolar disorder. “The combined cost of their medical treatment in the past six years has been more than $700,000, much of which my husband and I have paid for due to treatment limits, financial requirements, and downright payment denials by our health insurance providers.

“Our son’s serious mental illnesses have put us on the brink of financial disaster twice, forcing us to shift funds and work overtime while simultaneously caring for our sons. Unlike many other medical illnesses, many managed care plans reimburse mental illnesses only at 50 percent or 60 percent, leaving families to pay for the remaining costs. Our sons—who face a lifetime of potentially debilitating illnesses—need this legislation. Without it, our family and countless others with similar challenges face decades of financial hardships and worse.”

Sen. Kennedy said, “This is an issue that defines our humanity as a society and whether we care about fellow citizens. We, in Congress, have an opportunity with this legislation to shine a light on a dark corner of our society by making sure that we give those challenged by mental conditions the opportunity for progress and treatment.”

The APA press release on the parity bills is posted on APA’s Web site at www.psych.org/pub_pol_adv/paritybill_intro22703.pdf?. ▪