Federal Parity Law Gets Another Year of Life

Congress extended the limited mental health parity law through the end of this year as part of a flurry of legislative activity late last year.

The bill (HR 4579) will continue the 1996 Mental Health Parity Act for another year. It requires employer-sponsored insurance plans of businesses with more than 50 employees that provide mental health coverage to impose the same annual and lifetime dollar limits on mental health care benefits as they do on benefits for other types of disorders.

“We appreciate the efforts of both parties to ensure that the current law standards are extended so we don't lose ground,” said Nicholas Meyers, director of APA's Department of Government Relations.

Mental health advocates have not made an effort to push for a permanent extension of the limited-parity law because they continue to advocate for legislation that would provide full insurance parity for mental health care. Such a comprehensive parity measure would build on the 1996 parity law by requiring companies that offer mental health benefits to ensure that they are equivalent to those for physical illnesses on factors such as copayments, deductibles, and coinsurance.

The latest full-parity measure, the Paul Wellstone Mental Health Equitable Treatment Act of 2005 (HR 1402), is modeled on bills that have been introduced since Congress approved limited parity in 1996. The latest iteration of the bill, which was updated to include parity for drug addiction and alcohol abuse treatment, had 221 cosponsors by December but no action had yet been taken by either of the committees with jurisdiction, the House Education and the Workforce Committee and the House Energy and Commerce Committee.

In a November speech on the House floor, bill sponsor Patrick Kennedy (D-R.I.) noted that 2005 was the fifth year in a row that a majority of the House supported a full parity bill.

He said that in those five years American employers have lost more than $150 billion of productivity due to employee depression. In addition, during that same time more than 60,000 families were separated because relinquishing child custody to the state is the only way for many parents to get costly mental health care for their children. Kennedy urged the House leadership and the committees of jurisdiction to allow a vote on the bill.

Supporters believe eventual action on the bill is more likely to occur in the Senate, where mental health care advocates, including Sen. Pete Domenici (R-N.M.), have held closed-door discussions with Senate leaders and business opponents in an attempt to narrow differences over the legislation, according to Andrew Sperling, director of legislative advocacy at the National Alliance on Mental Illness.

“I think everyone recognizes the need for equitable coverage of mental health treatment,” he said. “It is just how we get there.”

Opponents have balked at what they see as another mandate on businesses and the use of the DSM-IV as the basis of coverage. But Meyers said progress in debunking earlier opposition based on the fear of increased insurance costs may add momentum to discussions on a bill that would be palatable to employers.

“What many seem to forget in this mix is that simply because someone has a diagnosable disorder under the DSM-IV does not mean that any insurance plan in the country is required to cover everything,” Meyers said. “There are always considerations given to severity of impact, and the legislation makes it clear that there is to be no impact on the ability of businesses and insurers to manage the benefit.”

Mental health advocates expect whatever bill that eventually emerges from the Senate negotiations to differ strongly from the House legislation.

The text of HR 1402 can be accessed at<http://thomas.loc.gov/> by searching on the bill number. ▪