Push for equity gains momentum

Congressman Patrick Kennedy of Rhode Island is garnering support for legislation to provide equitable health care coverage for mental health and addiction care. He is shown at an earlier event on social security in his home state. (photo by Tom Croke)

By Pamela Berard

Rhode Island's Patrick J. Kennedy was one of two Congressmen to embark on a national tour this winter to gather testimony for legislation that would ensure health plans offer fair coverage for mental health and addiction care.

Kennedy, a Democrat in the House of Representatives, and Jim Ramstad, a Republican from Minnesota, held forums in major cities across the country as part of the Campaign to Insure Mental Health and Addiction Equity. They gathered testimony from citizens who lives have been touched by mental illness and addiction.

Testimony from the tour, which included a forum at the Rhode Island Statehouse, will be used in an attempt to pass reintroduced federal legislation, the Paul Wellstone Mental Health and Addiction Equity Act. The bill expands the Mental Health Parity Act of 1996 by requiring group health plans to offer benefits for mental health and addiction care on the same terms as other diseases. The legislation closes loopholes that allow plans to charge higher co-payments, co-insurance, deductibles and maximum out-of-pocket limits and impose lower day and visit limits on care.

Kennedy expects the legislation will be introduced for a vote this month.

A similar bill was recently approved by a Senate committee. The Mental Health Parity Act of 2007 was approved in an 18-3 vote in the Senate Health, Education, Labor and Pensions Committee, and is a major step toward enactment in the Senate. The bill was officially introduced by Patrick Kennedy's father, Sen. Edward Kennedy, D-Mass., along with Pete Domenici, R-N.M., and Mike Enzi, R-Wyo.

If the Senate and House pass differing bills, a committee will be appointed to put together a compromise to go to President Bush.

"Americans with these physiological diseases of the brain pay their premiums like everyone else and their insurance should be there when they need it, like it is for everyone else," Kennedy says.

Kennedy notes that the hearings were successful and picked up momentum.

"The whole purpose of the hearing has been to not only solicit ideas for what should be in a bill but to mobilize strong support behind a real bill that guarantees real parity in benefits," Kennedy says. Among concerns that have been raised at the forum, Kennedy says that while states have been trying to pass parity laws to help protect residents from discrimination and insurance for those with mental illnesses, many employers are becoming self-insured in order to escape state mandates. "Hence this necessitates even more the federal legislation," which will affect plans that are currently exempt from state law, he says.

The Providence session was attended by representatives of the three commercial insurers in Rhode Island. "They know that the political dynamics have changed in Washington so that a bill is going to be voted on, for one. So now they have to come to the table and negotiate in good faith," Kennedy adds.

Additional forums were organized across the country by Mental Health America (formerly the National Mental Health Association) and the National Alliance for the Mentally Ill (NAMI).

Kennedy has been open about his struggles with mental illness, including bipolar disorder and entrance into an addiction recovery program. Ramstad, a recovering alcoholic, is Kennedy's recovery sponsor.

The parity bill had majority support in past Congresses but was blocked from consideration by House leadership. The new House leaders have made a commitment to Kennedy and Ramstad that they will bring the bill up for a vote, Kennedy says.

Kennedy emphasizes those affected by mental illness must remain united.

"The insurance companies know the greatest weakness we have as a mental health community is that we often are divided. We can't allow ourselves to do to each other what has been done to any one of us and that is to re-stigmatize."

Guaranteeing coverage for those with bipolar disorder but not those with chemical or alcohol addiction or with eating disorders just re-stigmatizes those left out, Kennedy says. "Frankly there will be a lot of resistance and effort to compromise, so to speak, in a bill and settle for something less than full parity and to me that will be undermining the most important principal of this which is the principal of stigma."

"We can't have lawmakers decide or have insurance companies decide what a mental illness is," he continues. "That should be determined by the medical community."

Including only some mental illnesses would be a "hollow victory," according to Kennedy. "People in this country need to stand up and demand their rights if they are to be recognized. If people don't, we are going to continue to be discriminated against as a community."

Push for equity gains momentum (March 2007 Issue)

Push for equity gains momentum
(March 2007 Issue)