Parity Is Also a State Issue!

If “conscience (meaning reflection) doth make cowards of us all,” those who reflect only on their own political security are cowards of the first class. I refer to the display of cowardice by Republican members of the House-Senate conference committee on the Labor, Health and Human Services, and Education appropriations bill on December 18.

The House conferees defeated, by straight party-line vote, an effort to include the mental health parity amendment championed in the Senate by Sens. Pete Domenici (R-N.M.) and Paul Wellstone (D-Minn.). The amendment would have prohibited discriminatory and unequal insurance coverage for mental illness treatment compared with that for physical illnesses.

Passage of the bill would have been a giant step toward the elimination of the stigma attached to mental illness and a recognition that many who are mentally ill can be treated and often cured and should be treated no differently from those with broken bones or cancer.

This vote occurred even though 244 members of the House of Representatives had indicated their support for the amendment by cosponsoring parity legislation or signing letters urging the inclusion of the Senate amendment in the final appropriations bill.

Clearly, the 10 House Republicans who scuttled this effort, which enjoys enormous support by the American public, were under great pressure from the House Republican leadership who, in turn, caved in to the demands of the insurance industry and big business.

After the vote, all that was left standing was a one-year extension of the current ineffectual federal parity legislation that was passed in 1996. Shame on the Republican leadership in the House and shame on those members who lacked the courage to enact a measure that provides fairness and equity to the 20 percent of Americans who, at one time or another, suffer from serious mental illness.

Given the lack of backbone demonstrated by these members of Congress, it now falls to those states that do not have comprehensive parity legislation in place to enact such measures as soon as possible.

In the 2001 session of the New York State Assembly, I introduced the Fair Insurance Act of 2001 (A 4506). This bill, if enacted into law, will eliminate discriminatory insurance coverage for mental health and substance abuse services. It mandates coverage for those illnesses and requires that the coverage be provided on the same basis as coverage for physical ailments.

It passed the Assembly in March and is now before the Senate Insurance Committee. The Senate sponsor is Sen. John Marachi (R).

Many of the same bogus arguments that were made to defeat the federal Domenici-Wellstone amendment were also used in Albany during the pendency of the N.Y. parity bill in the Assembly. We were regaled with claims that the cost of insurance coverage would skyrocket, ultimately resulting in fewer people being able to afford insurance altogether. This claim is nothing but a scare tactic by the insurance industry and is belied by all objective proof. Maryland, Minnesota, North Carolina, and Texas have all enacted parity legislation. Maryland experienced an initial increase and than a subsequent reduction to pre-parity levels. In Minnesota, one of the large insurance providers reported that the requirement would add only 26 cents to the monthly premiums paid by the 460,000 people enrolled with the company. After implementation of mental health parity for all North Carolina state employees, the state experienced a 32 percent reduction in the per member/per month cost of mental health services over a five-year period. Similarly, Texas experienced a more than 50 percent drop in the per person/per month costs when parity for state employees was enacted.

A parity study was commissioned in New York, and PriceWaterhouseCoopers has issued a preliminary report on the estimated costs of enacting this law. It estimated an increased cost of $1.26 per insured person per month—highly affordable and far from the insurance industry’s doomsday projections.

If we can make mental health and substance abuse services readily available to all insured individuals, many often disabling disorders can be diagnosed and treated earlier, thus placing less burden on public resources, businesses, and individuals themselves.

Now that the Fair Insurance Treatment Act of 2001 has already passed the New York State Assembly, and with the failure of parity legislation at the national level, it is imperative that the New York Senate hear from mental health consumers, their supporters and families, clinicians who provide such services, and the rest of us who, in all likelihood, in our lifetimes, directly or indirectly, will be affected by mental illness or substance abuse.

This year must be the year New York State enacts meaningful parity legislation, and it must be the year that we, as a nation, hold politically responsible those who shamefully traded the welfare of 20 percent of the American population for the wishes of the insurance industry. ▪