House Bill Ups Mental Health Coverage

Proposal Requires Insurance Companies to Offer Similar Coverage for Mental and Physical Health

By Todd Zwillich
WebMD Health News

Reviewed By Louise Chang, MD

March 5, 2008—The House passed a broad bill guaranteeing better mental health coverage for people with private insurance Wednesday, handing a victory to patient and medical groups that championed the bill.

The bill enforces mental health "parity." It forces insurance companies covering mental health treatment to offer the same level of coverage for it as they do for physical illnesses.

Current federal law requires insurers to cover the same amount of total lifetime spending for mental and physical diseases. But it leaves insurers free to charge higher co-pays and deductibles for mental illness treatment. It also lets them restrict the number of covered visits to a doctor or other mental health professional. Most insurance companies make use of such restrictions.

"Mental illness deserves treatment, and people who suffer from mental illness deserve to have their diseases covered by their health plans," says Rep. Brian Baird, D-Wash., who is a clinical psychologist.

"I urge my colleagues to vote against discrimination," says Rep. Steny Hoyer, D-Md., the House Democratic Leader.

Many mental health patient groups and medical societies have long fought for the bill. Congress has tried and failed to pass similar legislation for more than a decade. Some groups, including the National Alliance for the Mentally Ill, backed the Senate version, saying it was more likely to be signed into law.

Reconciling House and Senate Bills

Many of those same groups remain skeptical that Wednesday's bill can be reconciled with a significantly weaker version that passed the Senate late last year.

That bill allows insurers to choose which mental illnesses to cover. It also would negate potentially stronger state parity laws. Forty-two states have some form of parity on their books now.

Several conservative senators have already threatened to block the House and Senate from meeting to reconcile the two bills.

Sen. Pete Domenici, R-N.M, a key Republican co-sponsor of the Senate parity bill, says a final agreement could be impossible because the House was intent on passing a broad parity bill.

"I'm very sorry that they are. I worked very hard to try to convince them that we won't get health parity with that bill because we can't pass it in the Senate," he tells WebMD. Domenici, a champion of mental health treatment, has a daughter with schizophrenia.

The House bill doesn't require insurers to cover mental illness. Instead it requires those that already do to follow the new restrictions. It also exempts firms employing 50 workers or less and allows employers to opt out if their costs go up more than 2% in the first year.

SOURCES: Rep. Brian Baird, D-Wash. Rep. Steny Hoyer, D-Md. Sen. Pete Domenici, R-N.M. National Alliance for the Mentally Ill.

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