Congress has made significant progress toward enactment of health care reform over the past few months. We've been pleased to see all the major bills that will be reconciled into the final legislation address most of our top policy priorities. All would require new insurance plans for the uninsured to include mental health and substance use disorder services as essential components of the benefit packages. All these bills also include explicit references to the recently enacted Wellstone-Domenici parity law. We continue to advocate for a strong parity requirement to ensure that unequal limitations on access to care for behavioral health conditions are a thing of the past.

Parity Regulations: In that regard, we view the regulations implementing the new parity law as having wider implications than originally anticipated because they will likely inform new coverage of the uninsured through health care reform. Although the new parity law now applies to any new plans, which generally go into effect in January of 2010, the regulations have not yet been issued and are not expected for several months. The delay leaves health insurers with little guidance on how they should modify their coverage of mental health and substance use disorder services to comply with the new law.

In our comments to the federal agencies developing the regulations, we urged that they fully implement the intent of the law to eliminate discriminatory treatment of behavioral health care by ensuring that utilization management, medical necessity determinations, and provider networks are comparable between medical/surgical and mental health/substance use. These regulations present a key opportunity to close the kinds of loopholes plans have used in the past to undermine the principle of parity. Without the regulations in place, however, we fear that we will not see full implementation of parity in the 2010 plan year.

As a result, we joined with several other advocacy groups to engage Congress on this matter and are grateful for the leadership of Representative Patrick Kennedy (D-R.I.) and Senators Al Franken (D-Minn.), Sheldon Whitehouse (D-R.I.), and Jack Reed (D-R.I.) in championing letters that urge the Administration to issue these regulations as soon as possible. We were pleased that 73 Representatives and 26 Senators signed on to these letters.

Recognition in Health Reform: As our efforts on federal health care reform continue, we are encouraged that a number of additional provisions recognize the importance of mental health and addiction treatment. They include provisions to improve care coordination that specifically incorporate mental health and behavioral health and important workforce development proposals that seek to address shortages of behavioral health providers. The Senate Finance Committee's proposals to expand Medicaid to more low-income individuals includes an explicit provision to ensure that parity for mental health and substance use conditions would apply to these benefits. With respect to prevention, there are important proposals to improve access to school-based health care and home visitation programs.

With a number of hurdles still to overcome and crucial votes upcoming, we must keep up our advocacy to ensure that the critical provisions described above are included in the final bill. ::