Senate HELP committee passes mental health legislation

The Senate Health, Education, Labor and Pensions Committee on Wednesday voted 18-3 to approve a bill (S 558) sponsored by Sen. Pete Domenici (R-N.M.) that would require health insurers to provide the same level of coverage for treatment of mental illnesses and substance abuse as they provide for physical illnesses, CQ Today reports (Armstrong, CQ Today, 2/14).

The legislation -- also sponsored by Sens. Edward Kennedy (D-Mass.) and Mike Enzi (R-Wyo.) -- would exempt companies with fewer than 50 employees. In addition, the bill would exempt group health plans and companies in the event that the cost of coverage for treatment of mental illnesses and substance abuse exceeded 2% of the total plan cost in the first year or 1% in each subsequent year. The legislation would not supersede state mental health parity laws but would supersede state financial requirements and limits for treatment of mental illnesses and substance abuse (Kaiser Daily Health Policy Report, 2/13). Before passage of the bill, the committee by voice vote approved an amendment proposed by Sen. Christopher Dodd (D-Conn.) that would require the Government Accountability Office to study the effectiveness and cost of coverage for out-of-network providers of mental health services. Kennedy said, "No one questions the need for affordable treatment of physical illnesses. But those who suffer from mental illnesses face serious barriers in obtaining the services they need at prices they can afford" (CongressDaily, 2/14).

Some Concerns

Dodd cited the need for an amendment to clarify that the bill would not supersede broader state mental health parity laws. Dodd and Kennedy agreed to propose such an amendment to the legislation on the Senate floor, after interest groups have commented, rather than in committee. Enzi said, "If you violate that by adopting an amendment by this group, then you've undone the whole coalition, which means somebody's going to be fighting it when it goes to the floor." However, Sen. Richard Burr (R-N.C.), who voted against the bill, said, "Perfecting a bill, especially on the technical side, is not something you do on the floor. It's something you do in committee" (CQ Today, 2/14). Sen. Tom Coburn (R-Okla.) raised concerns that the bill would increase health care costs. He said, "For every 1% increase in health care (costs), 200,000 people lose their insurance." Coburn added, "We have an absolute shortage of psychiatrists in this country, and I don't see this bill helping that" (CongressDaily, 2/14).

Broadcast Coverage

WAMU's "The Diane Rehm Show" on Thursday in the first hour of the program is scheduled to include a discussion on the legislation. Scheduled guests on the program include Domenici; Kennedy; Paul Dennett, vice president for health policy at the American Benefits Council; Andrew Spelling, director of federal legislative advocacy at the National Alliance of Mental Illness; and Keith Dixon, president of Cigna Behavioral Health ("The Diane Rehm Show," WAMU, 2/15).

Audio of the segment will be available online after the broadcast.