Capitol Hill Update

Legislation Gains Face New Challenges, Grassroots Advocacy Must be Sustained

With the first session of the 110th Congress coming to a close, Congress is still struggling in the second week of December to meet its obligation to keep federal departments and agencies funded through the fiscal year. Presidential vetoes, further veto threats, policy and partisan differences, and limited time on the congressional calendar are all playing a role in lowering expectations for legislation and increased federal human services funding. Prospects for both held more promise earlier in the year. Although Mental Health America advocacy efforts had helped win impressive gains on multiple fronts through much of the session and we continue to try to resuscitate unresolved issues, few measures now appear headed to a successful outcome. Some key issues, like parity, are likely to be deferred until Congress reconvenes for a second session early next year. Others may not become ripe for action again until the next Congress.

The challenges we are now experiencing owe much to a hardened climate created when President Bush signaled his intention of using his veto pen more aggressively. This was first seen with the president's somewhat surprising veto of legislation that would have reauthorized and expanded the State Children's Health Program (SCHIP), a program he had supported in the past. (That bill would also for the first time have established a parity requirement in the SCHIP program.) The President's SCHIP vetoes set the stage for tough battles that are still underway and for deferring key reforms. With a single exception, congressional leaders have not been able to override these vetoes.

Earlier in the session, Mental Health America advocacy had helped win several important legislative gains, including Senate passage of a strong mental health parity bill; adoption of a House parity bill by three committees; House passage of legislation to end the 50 percent copay in the Medicare program; House and Senate passage of a provision to establish parity under the State Children's Health Insurance Program; congressional passage of an appropriations' bill that would measurably increase SAMHSA and other human services funding; and House passage of a veterans' bill mandating establishment of a national program to train returning service members for positions in peer-outreach and peer-support.

With a changed climate and challenges created by congressional "pay-as-you-go" funding rules (that require Congress to offset the cost of so-called "mandatory" funding increases, such as those affecting Medicare and Medicaid), earlier gains appear to have stalled or even blocked earlier progress.

What is clear, however, is even without definitive changes in law, mental health issues and concerns are now more widely understood, discussed and increasingly competing for congressional action. More and more policymakers understand that mental health is integral to overall health, and we need to maintain the strength of our voice and advocacy. Be sure to join Mental Health America's Advocacy Network and sign our Vision for Change petition at www.takeaction.mentalhealthamerica.net.