Advocates Rally To Demand Passage of Parity Bill
Patients, patient advocates, psychiatrists, and mental health professionals gathered on Capitol Hill last month to demand that Congress pass legislation requiring parity coverage for treatment of mental illnesses. See story at right and photos on Original article: page 17.
The Mental Health Liaison Group, with more than 190 member organizations including APA, organized the event to push for Congressional passage of the Mental Health Equitable Treatment Act (S 543, HR 4066).
The bill requires employers that offer mental health coverage to do so at the same level as for other illnesses, that is, without discriminatory copayments, deductibles, and out-of-pocket maximums.
Last year the Senate passed S 543, sponsored by Sens. Pete Domenici (R-N.M.) and Paul Wellstone (D-Minn.), as an amendment to an appropriations bill. House Republicans ultimately defeated the bill, however, during a joint conference in December. The bill has 66 cosponsors in the Senate.
In March Reps. Marge Roukema (R-N.J.) and Patrick Kennedy (D-R.I.) introduced HR 4066 in the House. The bill was referred to two subcommittees, but neither has acted on it yet.
Roukema told the crowd that 226 members of the House—a majority—have cosponsored HR 4066. “This overwhelming support follows President George Bush’s call for mental health parity and establishment of the President’s New Freedom Commission on Mental Health on April 29,” she said. (Psychiatric News, May 17).
Domenici praised the patient advocates in the crowd for their willingness to talk about stigma and discriminatory insurance policies. “We as a nation have decided to leave mental illness out. I say it’s time to put mental illness back in and insure it at the same level as other medical illnesses.”
Domenici also thanked Bush for calling on Congress in April to pass parity legislation this year and for promising to sign the bill.
Wellstone said, “This legislation says once and for all we will no longer accept stigma, we want to end discriminatory insurance practices, and we want full mental health coverage for men, women, and children!
“The only people we don’t have support from is the health insurance industry, and if they think they can stop parity, they can’t.”
Kennedy praised the grass-roots advocacy effort for “putting the pressure on Congress to pass parity last year, although the legislation was ultimately defeated by special interest groups.”
Patient Advocates’ Perspective
Kennedy also thanked Ron George, who addressed the crowd immediately before Kennedy spoke, for his willingness to talk about a painful subject. His daughter, Lisa, died at age 19 from medical complications of anorexia nervosa, a condition she was diagnosed with a few years earlier. Eating disorders affect 7 million women and 1 million men, according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD).
“When my daughter was hospitalized, she did regain the weight she had lost, but the underlying problem wasn’t addressed. Even when we paid out of pocket for daily counseling, it wasn’t enough to save her. What she needed was long-term intensive treatment, but that wasn’t covered,” said George.
Speaking on behalf of ANAD, George implored members of Congress to ensure that eating disorders are covered in any parity bill that is enacted.
“Early intervention in anorexia and bulimia is more effective and ultimately less costly than heroic treatment. ANAD estimates that the inpatient cost of treating eating disorders can run as high as $30,000 a month. But our insurance company paid $138,000 for 22 hours of extraordinary effort to save our daughter, and our daughter is dead. Nobody won.”
George was one of three patient advocates who described the personal costs of inadequate mental health insurance coverage.
Lisa Cohen, M.S.W., was diagnosed as a young adult with bipolar disorder and a rare blood disorder (idiopathic thrombocythemia). “Although both these disorders are life threatening, my insurance company chooses to view these illnesses with an unequal eye. The coverage for mental illness has been much harder to obtain. The benefits I have received have been discriminatory and incomplete,” said Cohen.
Her insurance plan has a 30-day limit on hospitalization for psychiatric disorders. “During a severe episode of bipolar disorder, the hospital planned to discharge me when my stay was 31 days instead of 30. I continued to be hospitalized only because my family intervened and paid the hospital for the additional days,” said Cohen.
“Meanwhile, my insurance company had no trouble paying for any and all care for my blood disorder, including more tests than I care to count. No questions asked, no limits on doctor’s visits or hospital stays.”
Jim McNulty, president of the National Alliance for the Mentally Ill, said that when he was diagnosed with bipolar disorder in 1987, his insurance plan provided no coverage for treatment of mental illness. “I was forced to seek treatment from a primary care physician who knew nothing about treating manic depression. I lost my job, my home, and my family.”
McNulty’s situation improved in 1994, when, as a resident of Rhode Island, he benefited from the state’s first parity law.
“Finally I was able to afford to see a psychiatrist who prescribed medication and regularly monitored my condition. The results of good treatment were rapid. I recovered from the depths of despair, started a business, and began helping others with similar problems,” said McNulty.
Cost Issues
Wayne Creelman, M.D., president of the Western Michigan Chapter of the Michigan Psychiatric Society, attended the rally on behalf of APA. Creelman told Psychiatric News, “I am impressed by the incredible support of members of Congress, the Mental Health Liaison Group, and the folks here who know that passing parity legislation is the right and timely thing to do.”
Creelman and several patient advocates attending the rally visited their Congressional representatives on Capitol Hill after the rally. Creelman is a Republican candidate for the Michigan legislature for the 9th District. “I am embarrassed to say that Michigan is one of the 15 states that have not enacted parity legislation. If elected, I will move passage forward.”
Creelman added that opponents in business and the insurance industry have unfairly labeled parity legislation before Congress as an unfunded mandated benefit. “We know that the costs to employers are pennies compared with the long-term cost savings. Parity is not a mandated benefit. The legislation applies only to employers who already offer mental health benefits and requires them to be covered at the same level as medical benefits.”
Creelman’s comments were supported by a May 22 memorandum from the Congressional Budget Office to “interested parties.” The CBO reaffirmed its August 2001 projection that enacting the Mental Health Equitable Treatment Act would, on average, increase insurance premiums by less than 1 percent (Psychiatric News, June 7). The CBO also concluded that the parity bill now before Congress doesn’t require health plans to cover services that are not medically necessary or new services they did not previously cover.
“Under the bill, plans would retain the ability to use exclusions of specific services, as well as medically necessity and other cost-management techniques,” according to the memo.
A memorandum to APA members on Congressional support of the parity legislation from Jay Cutler, J.D., director of the Division of Government Relations, is posted on the Web at www.psych.org/pub_pol_adv/parity52802.cfm. ▪
