President Bush To Endorse Expanded Mental Health Parity Legislation
President Bush is close to reaching a compromise with lawmakers to back expanded mental health parity legislation, the Washington Post reports. He plans to give a "strong" endorsement to the idea on Monday at a job training facility in Albuquerque, N.M., for people with mental illness. While details on the legislation may not be completed by then, those involved with the negotiations said Bush supports the idea of parity legislation and is likely to sign a bill this year (Milbank, Washington Post, 4/25). White House negotiators are talking with Sen. Pete Domenici (R-N.M.), a co-sponsor with Sen. Paul Wellstone (D-Minn.) of both the 1996 mental health parity law and a proposed expansion of the law, which died in Congress late last year (New York Times, 4/25). Wellstone has not been involved in the most recent talks (Washington Post, 4/25). The 1996 law, which expired last fall, prohibited insurers from establishing annual lifetime limits on mental health benefits that differed from those applied to other medical care. The proposed expansion would have required insurers that provide mental health coverage to offer those benefits at the same level as the benefits provided for physical health coverage with respect to both costs (such as deductibles) and access to services. The proposal was approved by the Senate as an amendment to the fiscal year 2003 Labor-HHS budget bill but removed in a House-Senate conference committee (California Healthline, 3/21).
Among the issues still not resolved is whether the legislation would apply to over 200 disorders, as Wellstone and Domenici have proposed, or be limited to "major" diseases such as schizophrenia and bipolar disorder, which the White House is thought to support. Another question is whether employers would be exempt from the law if costs were found to be too great. The Wellstone-Domenici proposal offers no exemption, but past discussions have considered offering exemptions if the parity requirement were to increase an employer's health care costs by around 1% to 3%. Despite the outstanding issues, the Post reports that support from Bush will likely give the legislation "a sufficient push to get ... enacted" (Washington Post, 4/25).
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