Mental health parity law nears expiration

Senators offer a bill that would go further than the current law toward making mental health coverage equal to other benefits.

By Geri Aston, AMNews staff. July 23, 2001.

Washington -- Congress is heading toward a crossroads on a law that aimed to put mental health insurance benefits more on par with medical and surgical benefits.

The Mental Health Parity Act of 1996 is set to expire in September. Congress has several options: Let the law die, reauthorize it or pass legislation expanding it.

Several reports conclude that the law's benefits have been more symbolic than real. Mental health advocates point to those findings as evidence that Congress should adopt a bill providing full parity between mental health and medical and surgical benefits.

The current statute prohibits annual or lifetime dollar caps on mental health benefits that are lower than those for medical or surgical benefits. But it allows more restrictive limits on the number of hospital stays or outpatient visits and permits higher co-payments for mental health care.

Reports show that employers and insurers, fearing an increase in costs, shifted from dollar limits on benefits to higher co-pays or hospital stay and outpatient visit restrictions. A General Accounting Office survey released in 2000 found that 87% of employers complying with the law imposed at least one of those allowed restrictions on mental health benefits in 1999.

Those practices have muted the law's effectiveness, say mental health advocates. "The impact has been minimal because the law has so many loopholes," said Paul Appelbaum, MD, president-elect of the American Psychiatric Assn. "It restricted one common way of limiting parity between mental and physical disorders, but allowed use of alternative methods." [...]