Mark Dombeck, Ph.D. was Director of Mental Help Net from 1999 to 2011. Dr. Dombeck received his Ph.D. in Clinical Psychology in 1995 ...Read More
Good news, kinda, this morning on the mental health insurance parity front. The United States House of Representatives has passed, by a vote of 268-148, their version of a mental health parity bill (H.R. 1424: the Paul Wellstone Mental Health and Addiction Equity Act), which, to borrow a quote from the New York Times story, requires "most group health plans to provide more generous coverage for treatment of mental illnesses, comparable to what they provide for physical illnesses". The House bill joins a similar Senate bill (S.558) passed back in September, 2007.
There’s no actual law yet. What has to happen now, as I understand it is for House and Senate committee members to get together and negotiate a way to reconcile differences in these two bills. There are some very important differences to reconcile which will deeply shape how many teeth the ultimate law that results from this process will have.
H.R. 1424 apparently mandates health insurers writing group health coverage for companies with 50 or more employees to cover all major DSM mental health and addiction diagnoses at levels comparable to how "physical" illnesses like cancer or heart disease would be covered. If you purchase an individual insurance plan, as usual, you are out of luck as the House version of the bill will not cover you.
If you think the House bill has its problems and exclusions, the Senate version is worse. S.558 is apparently much less restrictive on the insurance companies who would be allowed to choose which diagnoses they would cover. If they can choose which mental illnesses they can cover, how is the intent of the bill not already undermined from the start, I wonder? The version of the bill that people reading this site ought to be rooting for, IMHO, is the House version.
What exactly is the intent of the Senate version of the bill, anyway? As the San Francisco Chronicle article points out, federal law will override state law in this arena, so states which have more restrictive parity laws already may see those laws become unenforceable as the federal laws override them. To the extent that this scenario is a realistic possible outcome (something I’m not competent to judge) it makes me wonder just a little if the Senate version of the bill was intended from the start to engineer just this sort of mediocre, watered down outcome. In other words, the lobbyists behind the Senate bill may have been reasoning, "if we can’t fight off the idea of parity entirely, then at least we can hijack the idea of parity and turn it to our own ends". I wouldn’t put it past them.
Anyway, we’ll have to see how this drama continues to unfold. Hopefully, these more negative visions of what could be will not come to pass.