House Passes Bill Mandating Mental Health Parity

In early March, the US House of Representatives passed a bill that would require health insurance companies that offer mental health coverage to provide the same level of coverage for mental illness that they do for physical illness. However, it differs sharply from a bill passed by the Senate in the fall and it is uncertain whether the two measures '“ one sponsored by a father and the other by his son '“ can be reconciled.

The House bill, HR 1424, sponsored by Rep. Patrick Kennedy (D-RI), passed by a 268-148 vote - 221 Democrats and 47 Republicans voted for the bill.

Federal law currently prohibits health insurance providers from placing lower lifetime or annual limits on mental health coverage. However, most plans avoid these limits by charging higher co-payments for mental health coverage or limiting the number of doctor visits for mental illnesses.

The House bill would require health insurers who provide mental health coverage to offer that coverage on a par with other types of coverage. All mental illnesses listed in the Diagnostic and Statistical Manual of Mental Disorders would have to be covered by the plans. The bill provides $4.3 billion over 10 years in offsets, which would help insurers cover the increased costs of coverage. Plans offered by employers with under 50 employees would be exempt from the mental health parity requirements.

Critics have raised several objections to the bill, with some organizations worrying that the legislation will preempt state laws currently in place that require all insurers to provide mental health coverage. The House bill does not mandate mental health coverage, and advocates for the disabled have worried that insurers will simply not offer mental health coverage at all as opposed to offering coverage in line with the proposed law. Doctors are concerned about another provision in the bill that prohibits physicians from referring patients to hospitals in which they have a financial interest.

The House will now try to reconcile its bill with a less restrictive version passed by the Senate last September and sponsored by Rep. Kennedy's father, Sen. Ted Kennedy (D-MA). The Senate bill, S 558, would exempt group health plans and companies if the cost of coverage for treatment of mental illnesses and substance abuse exceeds a prescribed percentage of total plan costs. The U.S. Chamber of Commerce has called the House version of the bill "mental health insanity" and the Senate version a "careful compromise."

The elder Kennedy, was not optimistic that the two sides would come together, going so far as to say 'I don'™t think we'™ll go to conference.'

For a Kaiser Daily Health Policy Report article on passage of the House bill, click here.

For an earlier Special Needs Answers article on the two bills, click here.