Budget Resolution Allocates $5.4 Billion for Mental Health Parity

CongressDaily/AM today examines the status of mental health parity legislation in both chambers of Congress. A "little-noticed provision" in the fiscal year 2004 budget resolution passed in April, proposed by Sen. Pete Domenici (R-N.M.), would allocate $5.4 billion in a general health account over 10 years to offset lost tax revenues caused by increased premiums if mental health parity legislation were to be enacted. Domenici's provision would prevent the legislation from being challenged for not complying with the Budget Act. The "Paul Wellstone Mental Health Equitable Treatment Act" (S 486 and HR 953) would require equal coverage for all 200 mental illnesses catalogued in the Diagnostic Statistical Manual, a collection of widely recognized mental disorders. A 1996 law banning inequity for mental health coverage expires this year (Heil, CongressDaily/AM, 5/5). The new bill -- named in honor of former Sen. Paul Wellstone (D-Minn.), who sponsored it in the last congressional session and who died in a plane crash last October -- would eliminate a loophole in the 1996 Mental Health Parity Act, which mandated that health plans that cover mental illnesses could not establish different annual and lifetime benefits for mental illnesses than for physical illnesses. The Wellstone bill would prohibit those health plans from also establishing higher deductibles or copayments for mental health benefits than for other medical conditions (California Healthline, 2/28). The Congressional Budget Office has estimated that such legislation would increase health insurance premiums by 0.9% on average. Domenici said the Senate Health, Education, Labor and Pensions Committee may hold a hearing on the Wellstone bill and that the bill could go to the Senate floor later this summer. "It's going to happen here -- we could pass [the Wellstone bill] anytime here in the Senate," Domenici said.

The legislation is expected to "meet resistance" from House Republican leaders, CongressDaily/AM reports. Many representatives say they believe the legislation would raise premiums more than the CBO estimates. House members might support legislation that applies only to "more serious" mental illnesses. Domenici said he plans to meet with House GOP leaders to discuss the legislation, and CongressDaily/AM reports Domenici may narrow the scope of the bill to win support for it in the House. In addition, more limited parity legislation could produce a bill that could gain support from President Bush, according to CongressDaily/AM. Bush last year called for mental health parity legislation but said that he would not support a bill that would "substantially" increase premiums (CongressDaily/AM, 5/5).