Mental health breakthrough Insurance issue: Health coverage for mental ills on parity with physical ailments.


CONGRESS is making landmark strides in protecting greater access to health care for larger numbers of Americans. Having guaranteed that workers can carry their health insurance from job to job, regardless of pre-existing medical conditions, legislators have begun to break down entrenched discrimination against the mentally ill.

Under a bipartisan bill assured of President Clinton's approval, insurance companies offering mental health coverage would have to provide the same lifetime and annual payment caps for these illnesses as for physical ailments. But under a compromise provision required for passage, there would be no mandate that insurers have to offer mental health coverage. In that sense, the state of Maryland is way ahead of the curve. Under a bill passed by the General Assembly in 1994, health insurers are required to cover the mentally ill.

In addition to limiting restrictions in the mental health field, Congress is passing a Maryland-style provision allowing new mothers to stay in the hospital for 48 hours, and 96 hours after a Caesarean delivery. It also is providing health benefits for children of Vietnam veterans exposed to Agent Orange who suffer from the lifetime crippling disease, spinal bifida.

The breakthrough on mental health is the product of a long campaign by a Republican conservative, Pete Domenici, and a Democratic liberal, Paul Wellstone. Both have experienced mental disease in their own families. Senator Wellstone said "this moves us out of the dark ages." Senator Domenici said the parity bill was "a first step by Congress to bring the nation to terms with caring for the millions of Americans who suffer from diseases of the brain."

To succeed, the two senators had to overcome or mollify business leaders who fear additional mental health coverage will be so costly it will force companies to lower physical health benefits or end health coverage all together. By excluding companies with fewer than 50 employees and by eliminating any mandate requiring mental health coverage, the bill's sponsors lowered estimated costs dramatically.

While the business community remains wary, Senator Domenici contends that preventive and early care of serious mental disorders as part of the trend toward managed care can ultimately save billions of dollars. His goal appears to be a national plan somewhat similar to what Maryland already has.

Pub Date: 9/24/96

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