After more than a decade of lobbying for equal coverage for mental health treatments in health care plans, both the US Senate and the House of Representatives approved a bill yesterday that makes coverage for mental health on par with that now enjoyed for other medical issues. Still uncertain, however, is if the bill will become law, as the terms approved in the Senate are not the same as those approved in the House. Agreement is required before the bill can be ratified.
As federal law is currently written, insurers can set co-payments for mental health care much higher than for medical or surgical health care and strict limits to coverage can be imposed. Using a broken arm as an example, Rep. Patrick J. Kennedy (D-RI), one of the sponsors of the bill, says a typical scenario is to pay a small deductible, such as $200, and insurance coverage begins at once. If, however, the medical diagnosis is something like depression, schizophrenia, or even substance abuse, deductibles skyrocket, treatment is severely limited, and patients are faced with a multitude of co-payments to make out of pocket.
Kennedy says that new scientific and medical technologies now prove the very complex nature of the human brain, with clear physical evidence that compulsive disorders, including eating disorders, are of a physical nature and not simply a matter of choice. He feels the new technologies, and the approval of this bill, will finally take the stigma out of mental illness, often considered merely a character flaw and not a true medical malady.
As of now, equal coverage for both mental and physical illness is required in 42 states. Even so, as many as 82 million people in these states are covered under self-insured employer plans, exempt from state laws requiring equal coverage, while 31 million more Americans are covered by plans that do not offer coverage on an equal basis.
How to pay the federal government for equal coverage is one concern stalling the final draft of the bill, with the cost of equal coverage for mental health estimated at $3.4 billion in the next 10 years. Another source of further debate is the specific language with which the bill is written.
The House approved the mental health bill as stand-alone legislation involving no other issues. The Senate, however, included it in a $150 billion package that includes a multitude of tax cuts, including adjustments to the alternative minimum tax, extensions of tax provisions soon to expire that govern tuition credits, deductions for state and local sales taxes, and tax credits for research and development.
There is some concern a consensus will not be reached before Congress recesses several days from now, for the last time under the current administration.
Source: Washington Post