November 12, 2002
Congress Begins Post-Election Lame Duck Session
NAMI Advocates Push for Action on Parity and 2003 Spending Bills
Today Congress begins a "lame duck" session that is expected to extend into December. President Bush's proposal to establish a new cabinet level department for homeland security is expected to top the congressional agenda. However, members of Congress - many of whom will not be returning to office in January - will also be considering other issues including remaining FY 2003 spending bills and additional payments to physicians, hospitals and health plans under the Medicare program. It is also possible that Congress will consider action on legislation to require health plans to cover treatment for mental illness on the same terms and conditions as all other illnesses (insurance parity).
Mental Illness Parity Bill Still Alive
Increased attention has been focused on parity since the tragic death of lead Senate sponsor Paul Wellstone of Minnesota in a plane crash on October 25. During this "lame duck" session, there may be opportunities for members of Congress to press for action on a range of legislative priorities that were not acted on earlier this year. Parity is part of a long list of bills that was left unresolved before the election. However, few of these bills enjoy the strong bipartisan support that parity does in both the House and Senate and, most importantly, from President Bush. Only a handful of unpassed bills in the 107th Congress can match the record of accomplishment of the mental illness parity measure:
- vocal support from the President,
- 67 Senate cosponsors (over two-thirds of the Senate), and
- 242 House cosponsors (over half the House).
Despite this broad support for parity, there are still pockets of important opposition to parity (mainly from employer and insurance groups) that must be overcome. NAMI advocates are therefore strongly encouraged to contact their members of Congress and urge them to support passage of mental illness parity during the post-election "lame-duck" session. It is especially important that House members be urged to directly contact Speaker of the House Dennis Hastert (R-IL) in support of action on parity during the "lame duck" session. Please remind members of Congress that:
- untreated mental illness costs American businesses, government and families at least $113 billion annually in lost productivity and social costs,
- mental illnesses such as schizophrenia, bipolar disorder, major depression, obsessive-compulsive disorder and severe anxiety disorders are real illnesses,
- treatment for mental illness works and recovery is possible (treatment efficacy rates for the most severe mental illnesses exceed those for heart disease and diabetes),
- there is simply no scientific or medical justification for insurance coverage of mental illness treatment to be on different terms and conditions than other diseases,
- discriminatory insurance coverage of mental illness bankrupts families and places a tremendous burden on taxpayers through suicide, homelessness and inappropriate "criminalization" of people with mental illness, parity is affordable - the Congressional Budget Office (CBO) estimates that the current proposal before Congress would increase insurance premiums by less than 1% (a finding that is consistent with numerous previous studies that demonstrate how non-discriminatory coverage is economical and results in better treatment outcomes), and
- 34 states have enacted parity laws similar to HR 4066/S 543, but even these laws offer no protection for workers and their families that receive coverage through self-insured ERISA plans.
FY 2003 Spending Bills Remain Unresolved
The other major unfinished business for Congress in this "lame duck" session is the remaining appropriations bills for FY 2003 (which actually began on October 1, 2002). Currently, federal agencies and programs are operating under a "continuing resolution" that is keeping the government running through November 22. This "continuing resolution" is keeping last year's spending levels in place until Congress acts on the remaining FY 2003 appropriations bills.
Included in these unfinished spending bills is the Labor-HHS-Education Appropriations measure (HR 5320/S 2766) that includes funding for the National Institute of Mental Health (NIMH) and the Center for Mental Health Services (CMHS). Increases for both of these agencies are included in the Labor-HHS-Education spending bill; most importantly, a 7.8% increase for mental illness research at NIMH (raising FY 2003 funding to $1.359 billion). For CMHS (part of the federal Substance Abuse and Mental Health Services Administration), the Senate bill includes a $7 million increase for the PATH program (services for homeless individuals with mental illness) and level funding for the Mental Health Block Grant ($433 million). Greater details on the pending Labor-HHS spending bill are available here.
Funding for housing and veterans programs are part of a separate spending measure known as the VA-HUD Appropriations bill (HR 5605/S 2797) for which Congress has not completed action. It includes a $2.56 billion increase for veterans' medical care (including treatment and supportive services for veterans with mental illness). Both the House and Senate VA-HUD bills also contain funding for important housing programs at HUD including the McKinney-Vento Homeless programs, Section 811 supportive housing and the Section 8 rental voucher program. This includes funding to renew all expiring rent subsidies under the Shelter Plus Care program (permanent supportive housing for chronically homeless individuals with mental illness and co-occurring substance abuse disorders) and the Section 811 program (both tenant-based and project-based subsidies). More information on details of the FY 2003 VA-HUD Appropriations bill can be found here.
If congressional leaders and the Bush Administration are unable to reach a quick agreement on overall spending levels for these remaining appropriations bills then they will likely be forced into passing a long-term "continuing resolution" for FY 2003 - possibly through February or March of 2003. Such a long-term funding bill would delay most, if not all, spending increases for months, endangering critical priorities such as development of new mental illness research grants at NIMH, and renewal of key local services programs, (e.g., CMHS community action grants that many NAMI affiliates are engaged in).
NAMI advocates are therefore urged to contact members of Congress to support quick action in the "lame duck" session on both the Labor-HHS and VA-HUD Appropriations bills. Important increases for mental illness research, treatment and services programs should not jeopardized because of partisan gridlock. All members of Congress can be reached by calling the Capitol Switchboard toll free at 1-800-839-5276 or at 202-224-3121 or online through www.congress.org.