National Alliance on Mental Illness
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For Immediate Release, March 15, 2001
Contact: Chris Marshall
At a press conference today on Capitol Hill, Senators Pete Domenici (R-NM) and Paul Wellstone (D-MN) introduced legislation that ends insurance discrimination for people with severe mental illnesses. The new bill, the Mental Health Equitable Treatment Act of 2001 (S 543), would expand the very modest Mental Health Parity Act of 1996 and provide full parity in insurance coverage for serious brain disorders.
In a strong show of bipartisan support for this legislation, Senators Domenici and Wellstone were joined in cosponsoring S 543 by Senators Arlen Specter (R-PA), Harry Reid (D-NV), Lincoln Chafee (R-RI), Edward M. Kennedy (D-MA), Thad Cochran (R-MS), Jack Reed (D-RI), John Warner (R-VA), Christopher Dodd (D-CT), Pat Roberts (R-KS), and Charles E.Grassley (R-IA).
NAMI strongly endorses this legislation and passage of S 543 is NAMI's top priority of 2001. Grassroots action on S 543 is all the more important this year because the 1996 federal parity law expires on October 1, 2001.
FULL GRASSROOTS ACTION NEEDED
All NAMI members and advocates are encouraged to contact their Senators and strongly urge them to cosponsor S 543 and support this bipartisan effort to end insurance discrimination against children and adults with severe mental illnesses and their families. All Senators can be reached by calling the Capitol Switchboard at 202-224-3121. Fax numbers, email and mail addresses can be obtained by clicking on http://www.congress.org/.
In addition to calling Senators, NAMI members are also encouraged to write their Senators and include a personal story about how mental illness has personally affected themselves and/or their family, and how inadequate insurance coverage has limited access to effective and available treatments and services.
NAMI members who live in states of the Senators listed above who are cosponsors of S 543 are strongly encouraged to contact these Senators and thank them for supporting this legislation.
SUMMARY OF S 543
The bill seeks to ensure greater parity in the coverage of mental health benefits by prohibiting a group health plan from treating mental health benefits differently from the coverage of medical and surgical benefits.
The bill only applies to group health plans already providing mental health benefits and is modeled after the mental health benefits provided through the Federal Employees Health Benefits Program (FEHBP).
Full Parity for Mental Illnesses
Expands the Mental Health Parity Act of 1996 (MHPA) to prohibit a group health plan from imposing treatment limitations or financial requirements on the coverage of mental health benefits unless comparable limitations are imposed on medical and surgical benefits.
Provides full parity for all categories of mental disorders, including schizophrenia, bipolar disorder, major depression, obsessive-compulsive disorder, and severe anxiety disorders.
Coverage is also contingent on the mental illness being included in an authorized treatment plan, the treatment plan is in accordance with standard protocols and the treatment plan meets medical necessity determination criteria.
Defines "treatment limitations" as limits on the frequency of treatment, the number of visits, the number of covered hospital days, or other limits on the scope and duration of treatment and defines "financial requirements" to include deductibles, coinsurance, co-payments, and catastrophic maximums.
Requirements and Exemptions
- Eliminates the September30, 2001 sunset provision in the MHPA.
- Like the MHPA, the bill does not require plans to provide coverage for benefits relating to alcohol and drug abuse.
- There is a small business exemption for companies with 25 or fewer employees.
- The following is statement delivered by NAMI Board member Jim McNulty at today's Capitol Hill press conference.
FOR IMMEDIATE RELEASE
Federal Legislation Is A Vital Step in Ending Insurance Discrimination
Statement by Jim McNulty, Board Member
The National Alliance for the Mentally Ill (NAMI) fully supports the Mental Health Equitable Treatment Act of 2001. We are grateful for the leadership of Senators Pete Domenici (R-NM) and Paul Wellstone (D-MN) in seeking to end discriminatory health insurance coverage for children and adults with severe mental illnesses and their families.
This legislation will strengthen current federal law and finish the work that Congress began five years ago with the Mental Health Parity Act of 1996. It will extend to most Americans the equitable coverage of mental illnesses already available to federal employees and to Members of Congress under the Federal Employees Health Benefit Plan (FEHBP) program.
The Mental Health Equitable Treatment Act of 2001 is consistent with the findings of the U.S. Surgeon General's Report on Mental Health (1999)-that there is no scientific justification for health insurance to cover the treatment of mental illnesses on different terms and conditions from physical illnesses. With its enactment, families across the United States will have more equitable access to effective treatments that are essential to recovery.
The Mental Health Equitable Treatment Act of 2001 will require all health insurance plans to meet the standards set by the FEHBP, ending discriminatory treatment limitations and financial requirements. It would cover the full range of mental illnesses, including schizophrenia, bipolar disorder (manic depression), major depression, obsessive-compulsive and panic disorders, and serious childhood mental illnesses, among others. This legislation will strengthen the 1996 law by prohibiting unequal restrictions on annual or lifetime mental health benefits, inpatient hospital days, outpatient visits, and out-of-pocket expenses.
The approach is similar to that recently taken by many states. Today the majority of Americans live in states that have parity laws-32 states currently have such laws, with others expected to follow in 2001. But federal legislation is needed as well, in part because the federal ERISA law has allowed self-insured plans to escape state parity requirements. The legislation does, however, exempt small businesses with 25 or fewer employees from the requirements of the bill.
The total cost of parity is low, because the removal of discriminatory limits is replaced with processes for assessing the medical necessity of proposed treatments. Parity is both affordable and cost-effective. With parity coverage for the treatment of mental illnesses, businesses may also recapture some of the low cost through reduced absenteeism; reduced healthcare costs for physical ailments related to mental illnesses; increased employee morale; and increased overall productivity.
With the October 1, 2001 sunset of the 1996 federal law looming on the horizon, NAMI urges the Senate to act swiftly on this historic legislation. Now is the time to act.