Bush pushes for full parity in mental health coverage

President vows to work with lawmakers to reach agreement on the issue and establishes commission to study mental health system inadequacies.

By Geri Aston, amednews staff. May 13, 2002.

Washington -- President Bush's call for full equality in health insurance coverage for mental illnesses has drawn the spotlight back to congressional efforts to pass such legislation.

"Insurance plans too often place greater restrictions on the treatment of mental illness than on the treatment of other medical illnesses," Bush said in an April 29 speech. "As a result, some Americans are unable to get effective medical treatments that would allow them to function well in their daily lives. Our health insurance system must treat serious mental illness like any other disease."

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The president pledged to work with Sen. Pete Domenici (R, N.M.), a main sponsor of mental health parity legislation, and other lawmakers to reach an agreement on the issue this year.

Current law prohibits annual or lifetime caps on mental health benefits that exceed those for medical or surgical care. But health plans are allowed to impose higher cost-sharing requirements on mental health benefits and to restrict coverage of mental health care by limiting the frequency or length of treatment.

Bush called for an end to such practices, and Domenici's bill and a similar House measure would ban them.

Advocates of the parity bill, including the American Psychiatric Assn. and the AMA, immediately expressed gratitude for Bush's remarks.

But the issue is not without controversy. Health insurance and business groups vehemently oppose mental health parity legislation, which they view as a coverage mandate that would drive up insurance prices and increase the number of uninsured Americans.

Meanwhile, some lawmakers fear that a definition of mental illness that is too broad -- going beyond the most severe conditions -- could make parity legislation too costly. Bush did not offer specifics on what he would like to see in a bill.

Domenici's legislation would apply parity rules to conditions listed in the most current Diagnostic and Statistical Manual of Mental Disorders. It would not apply to small businesses.

In his speech, Bush also announced the creation of a commission that will study problems and gaps in the current mental health treatment system and recommend changes.

The APA praised Bush's move. "Hopefully, the commission will end our patchwork national policy on the coverage of treatment for mental illness," said Richard K. Harding, MD, the group's president. He pointed to disparity in mental health coverage in Medicare and noted that state Medicaid budgets are stressed and increasingly unable to pay for mental health care.