<nobr>Mar 10, 2008</nobr>

House Approves Mental Health Parity Legislation; ERIC Registers Opposition

Genetic Information Nondiscrimination Legislation Added

The House of Representatives on March 5 approved by a vote of 268-148, legislation (H.R. 1424) that would require parity between health insurance coverage of mental health benefits and benefits for medical and surgical services. The Senate approved similar legislation (S. 558) in September 2007, which means the legislation is now ready for a conference committee to iron out the differences between the two bills.

H.R. 1424 would require group health plans offering coverage to employers with more than 50 workers to apply the same treatment limits on mental health or substance-related disorder benefits as they do for medical benefits. The bill also would require group health plans to apply the same beneficiary financial requirements to mental health or substance-related disorder benefits as they apply for medical benefits, including limits on deductibles, co-payments, and out-of-pocket expenses.

ERIC Sends Letter to House Members

In a letter sent before the House vote, ERIC Vice President for Health Policy Edwina Rogers urged all Members to oppose H.R. 1424, saying that it would require those employers who are already providing coverage for mental ailments to meet even greater standards drafted by industry representatives who have a direct conflict of interest. Rogers also had testified against H.R. 1424 in June 2007 before the House Energy and Commerce Committee.

House Bill is More Draconian than Senate Version

The House bill is more extensive than the Senate bill because it includes a broader definition of conditions insurers would have to cover. The coverage would be based on the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) published by the American Psychiatric Association. For example, if made law, providers would be entitled to employer plan reimbursement for treating ailments for "conditions" such as jet lag, shyness, poor academic achievement, and sibling rivalry, which are all included in the latest edition.

To help pay for the $3.1 billion cost, the House bill also includes an increase in the rebate, or discount, that pharmaceutical companies are required to provide to State Medicaid programs for drugs provided to Medicaid beneficiaries, and language prohibiting physicians from referring patients to hospitals in which they have an ownership interest.

House Inserts Language of Genetic Information Nondiscrimination Legislation

Prior to the vote on H.R. 1424, House leaders inserted the legislative language of the Genetic Information Nondiscrimination Act (H.R. 493). The legislation would prevent group health plans and insurers from denying coverage or increasing premiums and deductibles for employees based on genetic information, and prevent employers from hiring, firing, or making compensation decisions based on an individual's genetic information. The genetic nondiscrimination legislation has been held up in the Senate over a "hold" by Senator Tom Coburn (R-OK). ERIC also has substantial concerns over the legislation, including the lack of a clear firewall between Titles I and II of ERISA. If made law, the legislation would expose employers to Equal Employment Opportunity Commission oversight and Civil Rights penalties in their administration of employee health benefits.

As previously mentioned, ERIC is opposed to any new mental health mandate, and will continue working to defeat the current legislation.

In addition to ERIC's letter opposing the legislation, below is a comparison of the House and Senate bills that the chambers will attempt to reconcile in conference. For previous coverage on the mental health parity legislation, refer to the October 17, October 1, and July 23 ERIC Executive Reports.

If you have any questions or comments regarding this issue, please contact either Edwina Rogers, erogers@eric.org, or Rohan Beesla, rbeesla@eric.org.

Text Files:

ERIC Letter to House Members

ERIC Side-by-Side Comparison
Websites:

H.R. 1424

S. 558

APA's DSM IV

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