National Alliance on Mental Illness
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September 20, 2002

Senate Panel to Consider Medicare Legislation

Senate Panel To Consider Medicare Legislation; Effort Launched to Address Discriminatory 50% Co-Payment Requirement for Outpatient Mental Illness Treatment Services

With prospects for a bipartisan agreement this year on Medicare prescription legislation fading, the Senate Finance Committee is planning to move forward on a package of increases for reimbursements for hospitals, physicians and HMOs. It is expected that as early as next week the Finance Committee will consider a package of these Medicare provider "givebacks" that could grow as large as $50 billion. The House passed a similar $30 billion package on June 28 as part of their Medicare prescription drug bill. The Senate was unable to pass a prescription drug bill, after more than two weeks of contentious partisan debate this past July. Despite this absence of agreement on outpatient prescription drug coverage for Medicare, Senate leaders appear determined to address the pleas of providers to add more money to the program - mainly in response to ongoing concerns that the Balanced Budget Act of 1997 has cut payments to providers too deeply.

Parity for Outpatient Mental Illness Treatment Services Under Consideration

The Senate Finance Committee Medicare package affords NAMI an important opportunity to push Congress to address perhaps the most discriminatory provision in the current Medicare benefit - the 50% copayment requirement for outpatient mental illness treatment services (all other medical-surgical outpatient services have a 20% beneficiary copayment. A bipartisan coalition of Finance Committee members is pushing for an amendment that would gradually lower the 50% copayment over the next decade.

The Finance Committee is under enormous pressure from many different provider and patient groups to include provisions that address a wide array of beneficiary concerns. Thus, NAMI advocates need to come forward and make the case for inclusion of an amendment to address parity for the 50% copayment for Medicare outpatient services.

Medicaid FMAP Increase Proposed

In addition to consideration of numerous changes to Medicare, the Finance Committee is also expected to take up a proposed temporary increase for the federal share of Medicaid - also known as FMAP. As state NAMI leaders know all too well, 2002 has been a very difficult year for state budgets. This is especially the case for Medicaid programs as governors and legislators have sought to cut both services and eligibility to hold down costs. Children and adults with severe mental illnesses have been especially vulnerable as states have moved forward on these cuts and NAMI affiliates have been very busy resisting these efforts to cut this critical safety net program.

Senator Jay Rockefeller (D-WV) is leading an effort on the Finance Committee to increase federal matching funds for state Medicaid programs by $6 billion over the next 18 months. An additional $3 billion would also be added to the Social Services Block Grant. NAMI strongly supports Senator Rockefeller's FMAP proposal as the most effective short-term means of preventing further cuts to Medicaid.

Action Requested

NAMI advocates are urged to contact members of the Senate Finance Committee and encourage support for:

  1. parity for the 50% copayment requirement for outpatient mental illness treatment services, and
  2. a temporary increase for the federal share of Medicaid (FMAP) in order to prevent further cuts in eligibility and services for Medicaid beneficiaries with severe mental illness.

NAMI members residing in the states of Senate Finance Committee members are especially encouraged to make phone calls and send e-mails. NAMI members that do not have a senator on the Committee can call their senators and encourage them to contact Finance Committee Chairman Max Baucus (D-MT) in support of both amendments. Below is a list of Finance Committee members.

All Senate offices can be reached can be reached by calling the Capitol Switchboard at 202-224-3121 or online through

Senate Finance Committee

Max Baucus (D-MT), Chairman
Jay Rockefeller (D-WV)
Tom Daschle (D-SD)
John Breaux (D-LA)
Kent Conrad (D-ND)
Bob Graham (D-FL)
Jeff Bingaman (D-NM)
John Kerry (D-MA)
Robert Torricelli (D-NJ)
Blanche Lambert Lincoln (D-AR)
James Jeffords (I-VT)
Charles Grassley (R-IA)
Orrin Hatch (R-UT)
Frank Murkowski (R-AK)
Don Nickles (R-OK)
Phil Gramm (R-TX)
Trent Lott (R-MS)
Fred Thompson (R-TN)
Olympia Snowe (R-ME)
Jon Kyl (R-AZ)
Craig Thomas (R-WY)