Advocates Celebrate House Passage of Mental Health Parity Bill

Mental Health America cheers historic step, sustains advocacy on other key issues

Conventional wisdom dictates that Congress accomplishes very little in a presidential election year. But it is still early in the congressional session and the House of Representatives has already passed a strong mental health insurance parity bill. That's not only a historic step but a critical development that has revived momentum behind parity, which hasn't seen action since the Senate passed its parity bill in September.

Parity Moves Forward

Some question whether the Senate and House will bridge their differences over parity legislation—which would provide equal coverage for mental and physical illnesses—but it is worth noting that Congress passed the original Mental Health Parity Act in a presidential election year.

Others see that a greater challenge may be winning agreement on a budgeting requirement that would offset the costs of parity as projected by the Congressional Budget Office (CBO). Because of its pay-as-you-go rules, Congress must take into account the CBO’s projections, which assume that parity will trigger a small increase in insurance premiums and a decrease in tax revenues as a result.

Notably, the House bill would offset those costs through two mechanisms: a measure that would limit doctors from referring patients to hospitals in which they have a substantial ownership interest, and a second provision that would increase the rebates that pharmaceutical manufacturers are required to provide state Medicaid programs. As the more than decade-long history of parity advocacy already suggests, we cannot take it for granted that a parity law will be enacted this year—and should be prepared to stay engaged and insistent.

Mental Health America Pushes for Improved Access to Care

Mental Health America is also looking to Congress to advance other objectives this year and to block steps that would create a setback for the mental health community. For example, Mental Health America continues to press for repeal of a higher coinsurance rate (50 percent) for outpatient mental health services under Medicare.

And we continue to press for improved access to services for returning veterans. Mental Health America recently testified at a hearing before the House Veterans Affairs Committee, which is considering the need for the Veteran’s Administration to significantly expand access to needed mental health services for families of returning vets.

Advocacy Blocks Restrictive Medicaid Rule but Work Remains

In addition, the Administration issued Medicaid regulations that would have dramatically reduced coverage for rehabilitative services and case management. Mental Health America’s advocacy work prompted Congress to successfully block the Administration from implementing new reimbursement rules for rehabilitative services through this June, but a new regulation that tightens case management coverage went into effect in March.

The rule would establish a number of restrictive and damaging changes. Among them, it would reduce coverage of case management for individuals transitioning from institutions to their communities from 180 days to 60 days or less. It would also severely limit access to case management for children in the child welfare system and for children receiving services in school settings. Advocacy efforts helped win adoption of a Senate provision that would bar implementation of this new rule through April of 2009. The Senate last month adopted that moratorium provision as an amendment to the Indian Health Care Act (S. 1200), which it passed. We are continuing efforts to win House passage of a companion moratorium bill.

If it seems as though advocates need to fight several battles at once just to hold their ground, that is probably an apt characterization. The Administration’s budget for the next fiscal year proposes very deep cuts to discretionary programs and is one of many that will set the stage for another debate regarding our nation’s spending priorities.

So stay tuned—and get involved by joining Mental Health America’s Advocacy Network at http://takeaction.mentalhealthamerica. net.