Mental Illness Insurance Update
Senators rebuffed in a previous attempt to improve insurance coverage for the mentally ill succeeded Thursday in passing a more modest proposal to reduce the gap with physical health insurance.
The measure, offered by Sens. Pete Domenici, R-N.M., and Paul Wellstone, D-Minn., would require that aggregate and annual payment limits be the same for mental and physical illnesses. Currently, for example, health insurance payments might be cut off completely after $25,000 for schizophrenia treatment, but the same insurer would pay up to $1 million if the patient had cancer. The measure, approved by 82-15, was attached as an amendment to a fiscal 1997 spending bill. There is no similar language in the House version of the bill.
Domenici and Wellstone led an effort to include full parity for mental health coverage in the recently enacted Kennedy-Kassebaum health care bill to guarantee that Americans can carry health insurance from one job to another.
The mental health provision was included in the original Senate-passed bill, but was removed when the House and Senate worked out their final version. Opponents argued that the costs of extending mental health care coverage would be too great on employers and insurance companies. "This compromise truly dramatically reduced our expectations and our hopes," Domenici said. But he said it would help the nation "get a little bit away from the rampant discrimination" that the mentally ill now face.
The amendment does not address other limits imposed on mental health services, such as higher co-payments or limits on outpatient visits or hospital stays. But Sen. Edward Kennedy, D-Mass., said it was an important first step. "Americans with mental illnesses and their families deserve a simple justice from employers, from the health insurance industry, and from their government."
Sen. Phil Gramm, R-Texas, charged that the measure would force up insurance costs and take away consumer choice. It tells consumers, he said, that "we know better than you do and we are going to make you buy the higher coverage or, in an incredible paradox, the way you can escape this is to drop mental health coverage altogether."
The Senate defeated, by 75-22, an amendment by Sen. Hank Brown, R-Col.,
that would have required insurance companies to offer the same payment
limits but give consumers the choice of picking a different plan. Gramm
won acceptance of language that would exempt policyholders if their premiums
go up by more than 1 percent as a result of the legislation.
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