December 28, 2006

By Frederic J. Frommer
The Associated Press

WASHINGTON, DC - After years of trying, advocates think they have a good chance of getting Congress to pass legislation next year that would require equal health insurance coverage for mental and physical illnesses, if their policies include both.

The legislation, named for the late Sen. Paul Wellstone, a Minnesota Democrat who championed the cause, has strong support in Congress but has run into GOP roadblocks. In the last congressional session, 231 House members -more than half of the chamber- signed on as co-sponsors. The GOP leadership, which in the past had expressed concern that the proposal would drive up health insurance premiums, wouldn't bring it up for a vote.

In 2003, Senate Democrats tried to win passage of the bill as a tribute to Wellstone, who died in a plane crash the previous year. Republicans blocked an attempt to pass it by unanimous consent.

"I'm very optimistic that 2007 will finally be the year that our health care system recognizes that the brain is, in fact, a part of the body," said Rep. Patrick Kennedy, a Rhode Island Democrat who sponsored the bill in the last Congress. "We've had majority support for this legislation six years in a row, and now we have a chance to bring it to the floor and pass it."

Kennedy has worked to erase the stigma of depression and other mental health problems. He has been candid about his own mental health, including being diagnosed with bipolar disorder, and he has won praise for speaking publicly about suffering from depression since his teenage years, taking antidepressant medication and regularly seeing a psychiatrist. He has also acknowledged being in recovery for alcoholism and substance abuse.

Kennedy's lead co-sponsor, Minnesota Republican Jim Ramstad, said a "silver lining" to the Democrats winning both houses of Congress is the increased chances of passing the bill, known as mental health parity.

"The Republican leadership would not give us a vote," said Ramstad, a recovering alcoholic who has pushed for improved treatment for those with alcohol and drug dependency.

Ramstad said that incoming House Speaker Nancy Pelosi, D-Calif., has told him the bill will come up for a vote on the House floor, which Pelosi spokesman Brendan Daly confirmed.

"We need to deal as a nation with America's No. 1 health problem," Ramstad said. "It's not only the right thing to do, but the cost- effective thing do."

Prospects have also improved in the Senate. Incoming Majority Leader Harry Reid, D-Nev., is a big backer of mental health parity, as is Kennedy's father, Massachusetts Democrat Edward M. Kennedy, who will chair the Health, Education, Labor and Pensions Committee next year.

Sen. Pete Domenici, R-N.M., who worked with Wellstone on the legislation, called the bill one of his top priorities in the next Congress.

A 1996 law already prohibits health plans that offer mental health coverage from setting lower annual and lifetime spending limits for mental treatments than for physical ailments. But backers want to see that expanded to things like co-payments, deductibles and limits on doctor visits.

Mohit M. Ghose, a spokesman for America's Health Insurance Plans, said that the trade group hopes to tackle the country's challenge of providing coverage to the uninsured in the next Congress.

"To accomplish this goal, we believe that consumers and employers must have the ability to choose the type of health care coverage they can afford and that most suits their needs," he said. "We hope that any discussion of mental health and other health care legislation will occur in this context next year."

J.P. Fielder, a spokesman for the National Association of Manufacturers, said his group doesn't support "additional mandates to health care coverage that will drive up these costs to employers." He declined to say whether he considered this bill to be a mandate, saying the group was still reviewing issues that will come up in the next Congress.

Andrew Sperling, a lobbyist for the National Alliance for the Mentally Ill, said the bill was not a mandate because it doesn't require insurance plans to provide mental health coverage.

"We don't want to get in the trap of making this a mandate," he said. "We believe this is a coverage condition."

He added: "We believe the brain is an organ like any other, and coverage should be equitable. Treatment is effective."

David L. Shern, president and CEO of Mental Health America (formerly the National Mental Health Association), said cost should not be a concern. He pointed to a study this year in the New England Journal of Medicine, which found that the government's decision to provide parity to federal employees in their health insurance plans did not drive up the cost of mental health care.

"I'm hoping we have nailed all of the concerns," Shern said. "It's the right thing to do, we have the data that says it's affordable, so our hope is this will be the year to set this benchmark nationally."