Sens. Olympia Snowe (R-Maine) reintroduced the Medicare Copayment Equity
Act in the Senate in late May. A companion bill in the House of
Representatives was reintroduced in March.
John Kerry (D-Mass.) reintroduced the Medicare Copayment Equity Act in
the Senate in late May. A companion bill in the House of Representatives was
reintroduced in March.
APA is leading the campaign that recently led to the reintroduction of
federal legislation to end the 50 percent copayment required for outpatient
psychiatric services under the Medicare program.
It is the second time the Medicare Copayment Equity Act has been introduced
by Sens. Olympia Snowe (R-Maine) and John Kerry (D-Mass.). They first
introduced it in April 2003.
"Medicare's current policy places an undue burden on individuals and
families suffering from mental illness, and our society as a whole,"
Snowe said in introducing the bill. "Not only will this legislation end
an outdated distinction between physical and mental disorders and ensure
Medicare beneficiaries have equal access to treatment for all health
conditions, it will also begin to eliminate stigmas and misunderstandings
associated with mental health disorders. I am proud to offer this legislation
to provide more equitable treatment to those struggling with mental
The legislation, which APA's Department of Government Relations has been
intensely involved in developing, is being hailed by more than 30 other
professional and advocacy organizations under the umbrella of the Mental
Health Liaison Group (MHLG).
A May 26 letter from the MHLG to Kerry and Snowe, initiated by APA,
outlined the group's opposition to the 50 percent copayment requirement."
We were fortunate to have all of those involved in advocacy for the
mentally ill behind us on this issue," said Nicholas Meyers, director of
APA's Department of Government Relations.
In a separate letter to the senators, APA Medical Director James H. Scully
Jr., M.D., expressed APA's longstanding interest in ending the 50 percent
copay requirement, which applies to psychiatric care but not other types of
"We are of course cosigners of the MHLG letter, but I wanted to add
my own personal thanks for your tireless efforts to end 40 years of
discrimination against patients seeking outpatient mental health services
under Medicare Part B," Scully wrote. "It should be simply
unacceptable to compel such patients to pay 50 percent of the cost of their
care out of their own pockets. The real winners under your legislation are
The MHLG letter, sent the same day, echoes those sentiments.
"Simply put, current law discriminates against Medicare beneficiaries
who seek treatment for mental illness," the group stated. "This
affects elderly and nonelderly Medicare beneficiaries alike when they seek
mental health care. According to the 1999 U.S. surgeon general's report on
mental health, almost 20 percent of elderly individuals have some type of
mental disorder uncommon in typical aging. In addition, elderly individuals
have the highest rate of suicide in the U.S., often the result of
The MHLG letter quoted the 1999 "Mental Health: A Report of the
Surgeon General," which noted that depression is particularly costly
because of the excess disability that it causes and its deleterious
interaction with physical health.
"The 50 percent coinsurance requirement also is unfair to the
nonelderly disabled Medicare population," the MHLG wrote to the
senators. "Because many of these individuals have severe mental
illnesses combined with low incomes and high medical expenses, a 50 percent
coinsurance obligation is a serious patient burden. For elderly and nonelderly
Medicare beneficiaries alike, Medicare is a critical source of care. Your
legislation to ensure that Medicare beneficiaries needing mental health care
incur only the same cost-sharing obligations as required of all other Medicare
patients would end the statutory discrimination against Medicare beneficiaries
seeking treatment for mental disorders." ▪