National Alliance on Mental Illness
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New legislation Provides Full Parity for People with Severe Mental Illnesses and Ends Insurance Discrimination
Senators Pete Domenici (R-NM) and Paul Wellstone (D-MN) have announced their plans to introduce new legislation early next week requiring health plans to provide full insurance parity for people with serious brain disorders. This new bill builds on an existing landmark law, the Mental Health Parity Act of 1996 (MHPA) also sponsored by Senators Domenici and Wellstone, that removed discriminatory insurance policies by equating annual and lifetime limits for mental health benefits with annual and lifetime limits for physical illness benefits. Although the MHPA was a historic first step by which Congress and the President declared that insurance discrimination is wrong and must not continue, many compromises were necessary to pass this legislation which resulted in the removal of many important measures that would have provided truly equal coverage. The Domenici-Wellstone parity legislation that is due to be introduced next week, is meant to address these issues by providing full parity for specific severe mental illnesses and by prohibiting limits on the number of covered inpatient days and outpatient days.
It is very important for NAMI grassroots and advocates to contact their Senators and urge them to support this new legislation with the following specific provisions when it is introduced. All Senators can be reached by calling the Capitol switchboard at 202-224-3121. Email and mail addresses can be found by going to the policy page on the NAMI website at www.nami.org and click on Write to Congress.
WHAT THE NEW LEGISLATION DOES
The new Domenici-Wellstone parity initiative takes a two-pronged approach to enhance insurance parity for people with severe mental illnesses. The bill will provide insurance parity for specified adult and childhood mental illnesses and prohibit limits on the number of covered days and outpatient visits for all mental illnesses. The proposal will specifically target for full parity "severe biologically-based mental illnesses." These brain disorders are:
For the purposes of the legislation, the term "severe biologically-based mental illnesses" means the above listed illnesses as defined by current medical science in conjunction with the Diagnostic and Statistical Manual of Mental Disorders (DSM IV).
One of the most troubling provisions of the MHPA that came about as a result of the legislative compromises, was the allowance of plans to restrict the number of hospital days and outpatient visits without regard to the patient's condition. In some cases, this provision negated the purposes of the law and some employees actually saw the number of covered inpatient and outpatient days reduced. The new Domenici-Wellstone bill will expand the MHPA to establish parity for the number of covered hospital days and outpatient days for all mental illnesses.
The new Domenici-Wellstone bill is also expected to contain some important requirement changes. The existing MHPA has a small business exemption and only applies to companies with over 50 employees. The new bill expands its scope and is expected to have a small business exemption that exempts businesses with 25 or fewer employees. Another important requirement change will remove the sunset provision of the MHPA, which only allowed the MHPA to be in effect until September 30, 2001. With this removal, the MHPA will not have to be re-approved by Congress and will be permanently in effect.
The NAMI E-News will continue to provide more details on this legislation and report on its status. For more information on the Mental Health Parity Act and the new Domenici-Wellstone bill, contact Chris Marshall at the NAMI offices at 703-524-7600 or visit the NAMI website at http://www.nami.org.