Legislation targets Medicare mental health inequality

But a tight budget and a lack of GOP support diminish prospects for mental health parity in 2003.

By Markian Hawryluk, AMNews staff. June 16, 2003.

Washington -- Mental health advocates are increasingly optimistic that Congress will reauthorize and strengthen federal laws requiring large private insurers to put mental health services on equal footing with physical health services. Yet Congress may still let the largest U.S. insurer off the hook.

Medicare mental health parity remains far down the list of priorities for lawmakers considering how to reform the health program this year without bankrupting the Medicare trust fund in the process.

Medicare pays only half the cost of beneficiaries' mental health services and has a 190-day lifetime limit on care in a freestanding psychiatric hospital.

"To deny that service is putting us back in the medical age of leeching and bloodletting. We're beyond that," said Rep. Fortney "Pete" Stark (D, Calif.). "To me it's immoral, it's obscene, it's shortsighted ... to deny mental health services to anyone who needs them."

Fears that full Medicare coverage for mental health services would result in a flood of new spending have caused lawmakers to resist moves toward parity thus far. But Stark vehemently discounts those worries.

"The idea that it costs more I think is pretty much trash," he said. "Denying the services may add to the cost in the long run."

Laurie Young, executive director of the Older Women's League, said there is no evidence to suggest that parity would cause Medicare spending to skyrocket.

"In fact, we know that parity is not that expensive," Young said. "We have more than six years of experience of parity in the insurance industry from the original Mental Health Parity Act, and we've shown that it doesn't dramatically increase costs."