Improved Health Coverage in US for Mentally Ill
Congressional leaders and the White House agreed Thursday to improve health coverage for new mothers and infants, mental health patients and children with spina bifida born to Vietnam veterans.
Sen. Christopher Bond, chairman of the Appropriations Subcommittee on Housing and Veterans' Affairs, said the legislation has the support of the White House and is expected to pass the House and Senate next week. The health care provisions were added to an $80 billion funding bill for housing, veterans' affairs and environmental agencies.
New mothers would be guaranteed at least 48 hours in the hospital after childbirth, if they chose to use it. Many insurance plans would be required to cover mental illness with the same level of benefits as provided for physical ailments. Some 3,000 children with spina bifida born to veterans exposed to Agent Orange in Vietnam would become entitled to disability benefits and health care. The reforms will put an end nationwide to so-called "drive-through deliveries" -- hospitals that force women to leave with their infants sometimes as soon as 10 hours after a normal delivery. The three health care changes are to be added to a must-pass spending bill providing money for federal housing programs, veterans' health care, environmental protection and space research. The maternity and mental health rules will take effect Jan. 1, 1998 while the spina bifida provision will start Oct. 1, 1997.
"This bill will require insurance companies to allow up to 48 hours when women go to the hospital for a normal birth and 96 hours in the hospital for women who have a Caesarean section," said Sen. Bill Bradley, a New Jersey Democrat who sponsored the maternal health insurance reform. To cut costs in recent years many insurance plans limited coverage to 24 hours or even less for a normal birth and 48 hours for a Caesarean-section. Women and doctors protested that not all women were ready to be discharged so quickly.
Bradley credited a unified front of outraged doctors and the public with forcing Congress to accept the change. The insurance industry was divided on the issue with major health plans such as Kaiser Permanente supporting the change. Bradley said he received 84,000 letters on the issue. The expansion of mental health coverage was expected to benefit 75 million Americans with group health insurance and those covered by government-funded Medicaid. While health plans will not be required to cover mental illness, those that do will no longer be permitted to set lower maximum payment amounts for mental health treatment.
If the health plan has no lifetime limit on physical care, none will be permitted on mental health care. The compromise exempts companies with 50 or fewer employees, rather than 25 or fewer employees as sponsors had wanted. Democratic Sen. Paul Wellstone of Minnesota and Republican Sen. Pete Domenici of New Mexico fought side-by-side for the mental health changes.
"Mental illness touches an awful lot of people out there," said Domenici whose daughter is one of 5 million Americans with severe mental illness. He fought for the expanded coverage when other senators told him he could not succeed.
To meet congressional budget rules, the provision was set to expire
Sept. 30, 2001. All three provisions passed the Senate with broad bipartisan
support but had not cleared the House, where Democrats this week forced
a non-binding vote endorsing the Senate plan. An estimated 3,000 children
of Vietnam veterans, many of whom are now adults, stand to share in about
$44 million disability benefits, job training support and health care provided
by Veterans' hospitals. The benefit was provided after studies showed a
link between children born with spina bifida and exposure to Agent Orange
while the father served in Vietnam.
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