Mental health breakthrough
A DECADE AGO, Congress acknowledged the heavy toll of mental illness by passing the 1996 Mental Health Parity Act. The law called for equalized insurance coverage in group health plans, so limits set on mental health benefits could not be stricter than the limits set on other medical care.
It was a start at ensuring that clinical depression, for example, doesn't take a backseat to appendicitis. But as a policy it was "half a loaf," and abused by insurance companies, as Senator Pete Domenici, a New Mexico Republican, said in an interview recently.
Indeed, the current law has loopholes that are easy to exploit. Health plans can still limit the number of mental health visits and increase deductibles without regard for parity.
So Domenici and senators Edward Kennedy and Michael Enzi, a Wyoming Republican, have hosted meetings among businesses, insurance companies, and mental health care providers, to come up with the Mental Health Parity Act of 2007.
Establishing parity in deductibles, copayments, and numbers of clinical visits, the bill passed in the Senate last week. It still has some gaps: It would apply only to companies with 50 or more employees, and it does not cover individuals who buy their own policies. But it could help 113 million people. The Congressional Budget Office estimates that it should increase the cost of employer-sponsored premiums by an average of 0.4 percent.
"Mental illness is just as treatable as physical illness," Kennedy said. Public policy should catch up to the advances in mental health treatments.
Now the challenge is working out differences between the Senate bill and one in the House. A difference is that the House bill - sponsored by Kennedy's son, Rhode Island Democrat Patrick Kennedy - would require coverage for all the mental illnesses that are covered by the insurance plan that members of Congress enjoy.
The Senate bill seems weaker: It would let businesses and insurance companies negotiate which mental illnesses will be covered. But the advantage of this proposal is that it has support from employers and insurance companies who were part of the legislative process. This should make them less likely to try to block passage of the law, or to duck it by simply deciding not to offer any mental health coverage - as they could legally do.
Such a compromise, however, demands vigilance. If the Senate's version, which has the support of the American Psychological Association, becomes law, Congress should monitor its execution to ensure that patients actually get better coverage. If parity remains elusive, Congress should crack down hard.
Healthcare reform remains a work in progress. But for now, it makes sense to enact the Senate bill and bring badly needed treatment to millions of Americans. 