NAMI Supports Domenici-Wellstone Bill For Full Insurance Coverage For Severe Mental Illnesses

Posted on May 18, 2000

The National Alliance for the Mentally Ill (NAMI) supports S. 796, the Mental Health Equitable Treatment Act, and recognizes the progress that today's hearing by the Senate Committee on Health, Education, Labor & Pensions (HELP) represents. We are grateful for the leadership of Senators Pete Domenici (R-NM) and Paul Wellstone (D-MN) in seeking to end discriminatory and harmful health insurance coverage for adults and children with the most severe mental illnesses.

This legislation will finish the work that Congress began in 1996. It will strengthen current federal law, building on a pattern that has been achieved at the state level since that time. It will expand parity for all Americans at a time when federal employees-including Members of Congress-will begin enjoying such coverage under the Federal Employees Health Benefit Plan (FEHBP).

S. 796 is consistent with the vision of last year's White House Conference on Mental Health. It is also consistent with the recent U.S. Surgeon General's report-the nation's first to address mental healthcare needs. Its time has come. The legislation recognizes severe mental illnesses as the real medical conditions that they are. With its enactment, families across the United States will no longer have to struggle to receive life-saving treatments that are essential to recovery.

The Mental Health Equitable Treatment Act will require full insurance parity for schizophrenia, bipolar disorder (manic depression), major depression, obsessive-compulsive and panic disorders, post-traumatic stress disorder, autism, and other severe and disabling illnesses such as anorexia nervosa and attention-deficit/hyperactivity disorder (ADHD). Insurers will be required to fully reimburse services for these disorders at the same level set for other physical conditions.

The approach is similar to that recently taken by many states, focusing parity on the most severe, biologically-based brain disorders. It establishes a legislative priority for coverage. Some states have gone farther in coverage than others. Last year, California, New Jersey and Virginia enacted laws that define much of the center of gravity for the nation. Today, 31 states have parity laws.

But federal legislation is needed. Too many disparities or gaps exist. In some instances, certain states may have been placed at a disadvantage.

State laws also do not cover the health plans of employees of self-insured companies, because of federal preemption under the Employee Retirement Income Security Act (ERISA).

To ensure fairness, the federal government must keep up with the states. Federal-state harmony needs to be maintained.

This legislation will strengthen the 1996 law by prohibiting unequal restrictions on annual or lifetime mental health benefits, inpatient hospital days, outpatient visits, and out-of-pocket expenses. It also prohibits limits on the number of inpatient days or outpatient visits for treatment of mental illnesses in general.

The total cost of parity-based on actual experience-represents less than a one- percent increase per year in the cost of health insurance coverage. Businesses with 25 or fewer employees also are exempted from the requirements of the bill. Parity is both affordable and cost-effective. With parity, businesses in fact stand to gain: from reduced absenteeism; reduced healthcare costs for physical ailments related to mental illnesses; increased employee morale; and increased productivity overall.

By enacting S. 796, Congress will reduce burdens on individuals, families, businesses and communities. It will help save lives. It will be an investment in both the workforce and America's future.