The Mental Health Parity Act of 2007 Continues to Move Forward
> 2/15/2007 11:01:27 AM

With broad backing from both sides of the aisle and strong support from insurers, The Mental Health Parity Act of 2007 (S. 558) has passed through the committee stage in the Senate and will now move to a full vote on the Senate floor. The folks at NAMI have pulled together a comprehensive review of the bill, which has had a storied 15 year history.

Speaking with Reuters, the bill's sponsor Sen. Pete Domenici (R-NM) said explained:

"The 1996 Mental Health Parity law only provided parity for annual and lifetime limits between mental health coverage and medical surgical coverage. The new bill expands parity by including deductibles, co-payments, out-of-pocket expenses, coinsurance, covered hospital days, and covered out-patient visits."

This is clearly a major step forward in federal parity legislation. Many states have passed parity laws that may or may not be effected, depending on the language in each state's law, but the fact that Washington is tackling the problem should not be overlooked. Even more significant though, is the fact that insurers are standing behind this bill 100%. Primary among them is Aetna, who serves nearly 36 million Americans. They've released a statement of support, saying in part:

Aetna is supportive of the principles and approach embodied in this legislation. If passed, we believe our members will benefit by being better able to achieve their optimal health through more integrated health and behavioral programs, benefits and services.

In reality, Aetna and other large insurers would be stupid to fight movement in this direction. Researchers have shown that parity, when combined with quality managed care, raises the level of overall care without increasing costs. Increasing care benefits to include mental health, while at the same time moving toward a preventative care paradigm, will cut costs in the long run by eliminating unnecessary ER and specialists visits that can often result from untreated mental disorders. The Mental Health Parity Act of 2007 is not a perfect bill -- as NAMI points out, it doesn't actually force insurers to provide mental health coverage, only parity; it also won't effect employers with 50 employees or less -- but the passage of this law will still mark an important moment in the push toward better coverage and treatment for individuals with mental health problems.


It's a step forward!
Posted by: Laura Collins 2/16/2007 12:18:47 PM

I'm a benefits manager for a large firm (more than 20,000 employees). Among a majority of my peers, outpatient mental health treatment continues to be plagued by doubts as to its effectiveness. OK fine under the new parity law, patients will receive more treatment - but what is the evidence that more outpatient treatment leads to better overall health? How long should the treatment take? Can or does outpatient therapy lead to reduced spending on physiological conditions, accidents, etc? Is outpatient therapy as some allege uniformly effective and provided only where clear indications lead to firm diagnoses? Or does it, as others allege, too often consist of hand-holding for the worried well?My opinion is that the various mental health organizations have not done nearly enough to help private payers such as insurance companies or even large self-funded companies such as mine, to understand the available scientific evidence relating to the effectiveness of outpatient mental health care. I'm not arguing that it's ineffective - I'm saying I don't know if it's effective. Iím also saying I don't have anything persuasive I can show my management. Mental health professionals want our plan to provide money for their services; isnít it reasonable to expect a persuasive cost-benefit showing?
Posted by: John Fembup 2/20/2007 8:02:56 AM

John,We linked to this NEJM study in this post: conclusion (at least from the abstract that is publicly available): "When coupled with management of care, implementation of parity in insurance benefits for behavioral health care can improve insurance protection without increasing total costs."Your point is a fair one though, as there hasn't been a surfeit of research to support parity. What there has been though supports it. There also exists a large body of evidence, which we've covered in the past (see here for one example), that shows that a large percentage of chronic illness is closely linked to mental health issues. Problems like alcoholism and drug abuse are primary among them, but depression, bipolar disorder and any number of anxiety and stress disorders can wreak havoc on the physical health of otherwise healthy employees. A forward thinking policy is one that advocates prevention by addressing mental health concerns early, before they become costly physical problems (both in terms of work lost as well as benefits). Parity is important because it shows people that insurers want them to seek mental health treatment when they think its necessary, thereby breaking down the reticence to seeking treatment and taking a preventative care approach that will reduce costs at many levels.
Posted by: TheEditorInChief 2/20/2007 9:53:48 AM

I am an avid supporter of the Mental Health Parity Act of 2007. However, I am confused about part of this act and wonder if you could clarify some information for me. Your posting on Feb. 15, 2007 states: "Speaking with Reuters, the bill's sponsor Sen. Pete Domenici (R-NM) said explained:'The 1996 Mental Health Parity law only provided parity for annual and lifetime limits between mental health coverage and medical surgical coverage.'"That statement leads one to believe that there is parity now between mental health and medical surgical lifetime limits, and that is not correct. My husband has been on long-term disability (LTD) since July of 2005. (He was diagnosed with Paranoid Schizophrenia in January 2003). He was eligible to receive 60% of his salary from his LTD insurance company, Prudential, until he was approved by Social Security for disability. At that time, the Prudential insurance was reduced by the amount of his Social Security check (this is a common practice).When my husband originally became disabled, his Human Resources Office at Hilton Hotels in Memphis, TN, told me that his benefits would continue until he was 62. It was 6 months later (or more) before I was informed by Prudential that HIS BENEFITS WOULD CEASE BECAUSE THERE IS A CLAUSE IN THE PRUDENTIAL CONTRACT WHICH LIMITS MENTAL ILLNESS BENEFITS TO 24 MONTHS. The customer service representative informed me that Prudential's definition of disability was not the same as Social Security's. I was shocked that this sort of discrimination was being allowed.Anyway, due to the disparity between mental and physical health benefits, my husband will lose his Prudential LTD July 19, 2007. The National Alliance for the Mentally Ill has been fighting this discrimination for 15 years (Loop holes are still being found to get around the Americans with Disabilities Act).Will the Mental Health Parity Act of 2007 make this type of discrimination illegal? As a mental health counselor, I am dismayed that any insurance company could discriminate against a person with Paranoid Schizophrenia and limit their benefits to two years. There is no cure for this mental disorder and it is debilitating and degenerative as I'm sure you know. I really appreciate any information and/or suggestions that you can offer.Sincerely,Mary Statum, M.S.
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