There’s been an awful lot of attention and debate today about the passage of the mental health parity bill. It requires that if a company with more than 50 employees offers mental health coverage as part of its overall health coverage, it has to offer it at the same level as coverage for physical health. (Sadly, it doesn’t require that the coverage be offered; only that if offered it be equal.)
Oh, you didn’t know that a mental health parity bill was passed today? You thought it was all about the economic bailout?
Well, you’re right, sort of; and most news reports have said the mental health bill was tacked onto the bailout bill. However, in fact it was the other way around. Section 7 of the Constitution of the United States says, “All bills for raising Revenue shall originate in the House of Representatives; but the Senate may propose or concur with Amendments as on other Bills.” So. while the bailout bill was the point, it couldn’t originate per se in the Senate. Senators needed a bill that they could originate and that they could attach the bailout to.
Enter the mental health parity bill. In fact it had already been passed in both the House and Senate, but hadn’t gotten to the President’s desk. In addition, it was a matter of interest to some members of the House who had voted against the bailout plan the first time around. So, being generally acceptable and especially acceptable to some additional Representatives, it made a great vehicle for the purpose.
Parity for mental illness and addictions has been an issue for a long time. Parity had long suffered from the lingering stigma associated with mental illnesses themselves. Insurers resisted it, noting that mental illnesses were often difficult to diagnose, and were chronic, requiring years of treatment. On the other hand, with medical progress many with mental illnesses could be economically and socially functional with appropriate treatment. The same could be said for other chronic, complex diseases, such as diabetes or autoimmune disorders, which were covered. The logic for offering unequal coverage for mental illnesses could not be sustained.
So, today the House passed and the President signed a mental health parity bill, that happened to have an economic bailout bill attached (okay, so it’s not a coincidence). Of course, we’ll be living with the consequences of that economic rider for some time to come. On the other hand, for some the benefits of the mental health parity bill will make a difference for a lifetime.
Update: Yesterday on All Things Considered, NPR had coverage of the history and the importance of passage of the mental health parity legislation. It's an interesting and useful summary. You can read or listen here.