House Passes Historic Mental Health Parity Bill

On March 5, 2008, the U.S. House of Representatives passed H.R. 1424, the Paul Wellstone Mental Health and Addiction Equity Act. This historic legislation, which was sponsored jointly by Congressman Patrick J. Kennedy (D-R.I.) and Congressman Jim Ramstad (R-Minn.), is named after the late Senator Paul Wellstone. It aims to realize Senator Wellstone's vision to establish equality in terms of mental health and addiction coverage.

The legislation was cosponsored by 274 members of Congress and passed with a strong bipartisan vote of 268 to 148. Forty-seven Republicans joined 221 Democrats in voting to pass the bill; three Democrats and 145 Republicans voted against passage.

The new legislation seeks to expand the 1996 Mental Health Parity Act, which requires equality only for annual and lifetime limits. H.R. 1424 requires parity across the terms of the health plan. For example, the plan or coverage must ensure that any financial requirements that are applied to mental health and addiction benefits (for example, deductibles, copayments, and out-of-network charges) are no more restrictive or costly than those applied to comparable medical and surgical benefits that the plan covers.

Members of both houses must now work to reconcile H.R. 1424 and the Senate's Mental Health Parity Act of 2007 (S. 558). Unlike the Senate bill, the House version would mandate coverage for all mental and substance use disorders listed in the DSM, which is the same standard of the Federal Employee Health Plan that members of Congress use. Critics say that provision would force companies to finance treatment for disorders such as caffeine addiction. Advocates argue that broad coverage prevents "discrimination by diagnosis." Medical necessity requirements and other managed care techniques can be used to limit costs and services, even if all conditions in the DSM are covered. This is how costs are contained for general medical services in insurance in which all health conditions are typically covered.