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The Window on Parity Legislation
is Closing
December
5, 2001
The window on parity legislation is closing. Please call the office of the
Speaker of the House, Rep. Dennis Hastert (R-IL), at 202-225-0510 or
1-866-PARITY-4 (and ask for the Speaker's Office). Urge him to join the
244 other Members of the House who support the enactment of mental health
parity legislation. Call today and every day.
Don't Let Leaders Thwart
Majority's Support for Parity
Last Push Needed!
Update on Conferees: 1.
House Republicans on the Labor-HHS-Education conference committee are
telling advocates they have concerns about accepting the Senate-passed
parity amendment because it is authorizing legislation. They are being
pressured by the chairs of the three pertinent authorizing committees to
reject the provision. We need one last push - particularly through the
members of those Committees -- to urge the authorizing committee chairs to
lift their objections.
House majority supports parity: Although powerful committee
chairmen have been working to block parity, a majority of the House has
signed a "Dear Conferee" letter circulated by Rep. Marge Roukema urging
the conferees to adopt the Senate-passed parity provision. The 220 members
signing this letter include 33 Republicans. Still other members who have
not signed this letter have signaled their support for parity by
cosponsoring H.R. 162 or sending separate letters of support. Much credit
goes to MHAs for your work in winning this support.
Still Time for Advocacy: There is still time to use the phones in the next
very few days to win additional converts to parity, and it is particularly
important to gain support from members of the three authorizing
Committees.
Action Needed:
1. Man the phones and call 1-866-PARITY4, our Legislative Hotline, to call
House Republicans who sit on these key health committees to urge their
support for the mental health parity amendment to the Labor-HHS
Appropriations bill:
Message: "I'm calling
to urge the Representative to work with Labor-HHS Appropriations conferees
to accept the Senate's mental health parity amendment. This legislation
will help families by banning arbitrary limits on needed mental health
services."
2. Call the Republican cosigners of the Roukema letter (using our
Legislative Parity Hotline -- 1-866-PARITY4) and both thank them for their
support and urge them to talk with Chairman Regula in support of accepting
the parity amendment. Those Republican supporters are Bachus (AL),
Boehlert (NY), Henry Brown (SC), Ehrlich (MD), Emerson (MO), English (PA),
Foley (FL), Forbes (VA), Ganske (IA), Gilchrest (MD), Gilman (NY),
Greenwood (PA), Grucci (NY), Horn (CA), Kelly (NY), King (NY), Kirk (IL),
LaTourette (OH), Leach (IA), LoBiondo (NJ), McHugh (NY), Morella (MD),
Jerry Moran (KS), Platts (PA), Quinn (NY), Ramstad (MN), Roukema (NJ),
Saxton (NJ), Shays (CN), Simmons (CN), Chris Smith (NJ), Walsh (NY) and
Wilson (NM).
3. Keep the pressure on Republican Members
of the House Labor/HHS appropriations committee (calling them on the
parity hotline number): Chairman Ralph Regula (OH); Bill Young (FL);
Ernest Istook (OK); Dan Miller (FL); Roger Wicker (MS); Anne Northrup
(KY); Duke Cunningham (CA); Kay Granger TX); John Peterson (PA); and Don
Sherwood (PA).
Message: "We need your support to adopt the Domenici-Wellstone
mental health parity legislation. A majority of the House - including many
Republicans -- has called for passage of this legislation. Please don't
let issues of congressional turf or myths being spread by opponents stand
in the way of adopting this legislation."
See the paper below, which provides rebuttals to the
many myths opponents have concocted to combat and defeat mental health
parity legislation.
For more information on parity, contact Ralph Ibson, Vice President for
Government Affairs, at 202-675-8388 or
ribson@nmha.org.
End Discrimination Against People with Mental Illness: Let's Get Past
the Myths and Solve the Insurance Problem
The Senate-passed Domenici-Wellstone amendment to the FY 2002 Labor-HHS
appropriations bill aims to end discrimination against mental illness in
health insurance coverage (mental health parity). The amendment simply
says that employers (with more than 50 employees) that choose to provide
mental health coverage must offer in-network coverage under the same terms
and conditions as medical and surgical coverage. Opponents have responded
to the amendment with a series of myths.
Myth 1. The Senate parity provision is unduly restrictive and intrusive.
The Reality. Far from being restrictive, the Senate-passed language gives
employers great latitude to design coverage and contain costs, specifying
that they: (1) are not required to provide specific mental health
services; (2) are not required to provide coverage unless services are
medically necessary; (3) get to define what constitutes medically
necessary treatment; (4) are free to employ managed care techniques; (5)
are not required to provide parity for out-of-network services; and (6)
are not required to
provide mental health coverage. It should be clear that this legislation
strikes a careful balance between protecting people in need of mental
health care from discriminatory barriers and protecting employers from
unreasonable mandates, costs, or burdens.
Myth 2. Discriminatory, severely limited coverage of mental health care
must be employed to protect against overutilization.
The Reality. Citing a "growing body of research and actual industry
experiences," the Federal government found that State parity laws have had
only a small effect on premiums due primarily to careful management of
mental health services. (www.opm.gov/insure/health/parity/qanda.htm)
The Domenici-Wellstone amendment makes it crystal clear that the full
panoply of managed care techniques can be brought to bear, including
retrospective utilization review and utilization management practices.
There is no foundation, therefore, to suggest that arbitrary,
discriminatory limits on treatment or disparate cost-sharing must be
imposed to insure against overutilization.
Myth 3. The legislation is unreasonably broad.
The Reality. Opponents imply, without any foundation in the legislation,
that the measure requires coverage for any psychiatric diagnosis. In
ridiculing a handful of obscure diagnoses, opponents selectively ignore
the clear import of this legislation: parity is required only as to
services that are medically necessary under the plan or issuer's criteria
and then only if the services are part of an authorized treatment plan
that is in accordance with standard treatment protocols. Clearly those
writing insurance coverage can readily protect against unwarranted costs.
Opponents' suggestion that the legislation should be narrowed to cover
only the "most serious" conditions highlights the invidious problem this
legislation aims to end. Narrowing parity coverage to a handful of
psychiatric disorders would exclude most children with emotional disorders
and adults with a range of serious disorders, such as post-traumatic
stress disorder. Limiting care based on perceived degrees of seriousness
among mental illnesses is just as wrong as it would be if insurers
proposed limiting coverage of "less serious" cancer or cardiovascular
disease.
Myth 4. Simply extending the 1996 Mental Health Parity Act would
resolve the problem.
The Reality. The 1996 law had been only minimally effective in ending
discriminatory insurance practices. As the General Accounting Office
documented in a report to Congress last May, many of the opponents of this
legislation completely circumvented the 1996 law by erecting new barriers
(in the form of discriminatory limits on numbers of covered outpatient
visits and days of hospitalization as well as higher cost-sharing
burdens). In so evading the spirit of the 1996 Act, parity opponents
continue to deny
people access to needed mental health care. Congress should not reward
efforts to frustrate its intent by re-enacting a law so readily
circumvented.
Myth 5. Parity will be unduly costly.
The Reality. The Congressional Budget Office (CBO) has projected that
enactment of the Senate provision would result in premium increases of
only .9%. Experience in the many states which have passed parity laws
closely mirrors the CBO projections. The Federal government characterized
the argument that the cost of mental health parity is prohibitive and
would result in fewer people having insurance as an "apparent myth." (www.opm.gov/insure/health/parity/qanda.htm)
Clearly, these CBO projections; the experience of both states which have
enacted parity laws and of the Federal Government in implementing parity
in the Federal Employee Health Benefits Program; and the many studies on
the subject belie the bald claim that enactment of this measure would be
costly.
Myth 6. Parity will be harmful.
The Reality. Such a claim, based on the myth that parity will be costly,
simply ignores the facts. Opponents ignore entirely both the compelling
data on how little parity costs and the reality that workers with
untreated or undertreated mental illness add some $70 billion annually to
employer costs through absenteeism, turnover and retraining expenses,
lower productivity, and increased medical costs. Enactment of mental
health parity legislation, rather than having an adverse impact, can be
expected to
increase productivity and economic gain.
Myth 7. Employers need to be exempted from parity requirements if their
health plan premiums increase by more than one percent.
The Reality. Such a cost exemption is a formula for gutting this
legislation. Since premiums are expected to increase on average by only
.9% under the legislation, exempting employers whose costs increase only
marginally above 1% would mean most American workers would be denied the
protections of this law. It would be untenable to provide for an outright
exemption based on costs and thereby free an employer from ANY obligation
under the Act. Establishing such an exemption would mean, for example,
that an employer that was required to provide parity as to lifetime and
annual dollar limits (under the 1996 mental health parity law) would be
freed of even that obligation by virtue of some demonstration of a modest
increase in
costs resulting from new parity requirements.
Myth 8. Now is not the time to enact parity.
The Reality. Mental health parity is not a new concept. We have the
benefit of years of experience and available cost data in the 32 States
which have enacted and implemented mental health parity legislation. That
experience informed the Federal government and enabled it on January 1,
2001 to implement mental health parity for all Federal employees and their
dependents, including Members of Congress and their staff - with minimal
cost impact -- through the Federal Employee Health Benefits Program.
Parity has undergone years of study. House Committees, facing a September
30 sunset of the 1996 Act, have had months to schedule hearings on the
Mental Health and Substance Abuse Parity Amendments of 2001, H.R. 162, a
measure which has nearly 200 cosponsors. Yet no action was taken. It is
time for jurisdictional concerns to yield to the needs of children and
adults with mental health disorders. It is time to recognize that this
issue has had ample study. It is time to act.
All the Domenici-Wellstone amendment would do is extend to American
workers the same parity protection which the Federal Government has
provided all Federal employees and their dependents including Members of
Congress and their staffs. It is time to enact the mental health parity
legislation overwhelmingly adopted by the Senate - now more than ever.
Do not allow these myths to cloud the reality that the Domenici-Wellstone
amendment is a carefully crafted, balanced measure which is long overdue,
and will contribute to our economic well-being and benefit American
workers and their families. |
