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Other Parity News
Millions of Americans with mental disorders do not have equal access
to health insurance. Many health plans discriminate against these
people by limiting mental health and substance abuse healthcare by
imposing lower day and visit limits, higher co-payments and deductibles
and lower annual and lifetime spending caps.
The National Mental Health Association (NMHA) and is local and
state affiliates support comprehensive health insurance parity
legislation, which would ban these practices by requiring the same
health insurance coverage for mental disorders as physical disorders.
State Actions
To date, 34 states have made into law some form of mental health
parity. Several have enacted laws that require insurance parity
only for a small set of specified diagnoses or serious mental
illnesses, however. These laws discriminate against children
and adult whose illnesses can be as disabling as those specified
in the laws, but do not fit neatly within the statutes’ criteria.
Adults excluded from protection under these laws include those
who have multiple personality disorders, anorexia nervosa and
bulimia, post-traumatic stress syndrome, and substance abuse
disorders. Children with serious emotional disturbances and substance
abuse disorders are also excluded. Therefore, NMHA advocates
for inclusion in laws all disorders listed in the Diagnostic
and Statistical Manual of Mental Disorders—IV (DSM-IV).
The laws in three states can serve as models for legislation
other states that are either considering the issue for the first
time
or are considering revising their existing parity law. These states
are Vermont, Maryland and Connecticut. To obtain copies of these
states’ laws, as well as NMHA’s parity-related reports,
contact NMHA’s Advocacy
Resource Center.
Federal Parity
In 1996, Congress passed the Mental Health Parity Act (P.L. 104-204),
which made it unlawful for companies with more than 50 employees to
set annual and lifetime dollar insurance limits for mental health care (unless
the same dollar-limits apply to medical and surgical care). Many employers
and insurers violated the spirit of that law, however, by placing other
restrictions on mental health benefits, such as limits on the number
of
covered outpatient office visits and number of days for inpatient care.
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Web Resources on Parity
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Repeated legislative efforts in Congress to close these loopholes have
won broad bipartisan support. President Bush at one time expressed support
for, and pledged to push for enactment, of parity legislation, but has
not renewed that call. Congressional leaders have blocked efforts to bring
an
expanded parity bill to an up-or-down vote, however, and Congress has
instead simply kept the 1996 law in force, through a series of one-year
extensions.
This year, Reps. Jim Ramstad, R-Minn, and Patrick Kennedy, D-R.I., have
introduced the Senator Paul Wellstone Mental Health Equitable Treatment
Act, H.R. 1402, a measure that would require employers with more than 50
employees to provide comprehensive mental health and substance-use parity.
While a parity bill has not been introduced this year in the Senate, Sens.
Pete Domenici, R-N.M., and Edward Kennedy, D-Mass., who sponsored parity
legislation in the last Congress, continue to work on this issue behind
the scenes with an eye to passing a bill this year. To stay up to date on
what’s happening in Congress on mental health parity legislation,
check out our latest Legislative
Alerts.
Technical Assistance Resources
NMHA has developed a series of resources to help advocates in their
parity campaigns. In addition, NMHA will research additional questions
on this important topic. The following documents are available through
the Advocacy Resource
Center:
- Expanding Mental Health Parity Toolkit. This toolkit provides
background information for people who are amending their current
parity laws are
working to pass parity for the first time. Toolkit contents include:
MHA Contact List; Expanding Parity Fact Sheet; Skeleton Media
Announcement; State Insurance Parity Laws Charts; Advocacy Check List
for 2001;
Substance Abuse Insurance Parity: A Guide for Advocates; Media
information on
the Surgeon General's Report; Why Mental Health Parity makes
Economic Sense; State Parity Language for Children; and Parity Case
Study: Connecticut.
- Strategies for Negotiating Comprehensive Parity.
Discusses strategies for keeping the parity debate focused on providing
protections
for all Americans along with specific responses to scenarios
that could
jeopardize comprehensive or full parity proposals.
- Substance
Abuse Insurance Parity: A Guide for Advocates. Provides background
information on the issues surrounding substance
abuse
parity.
- Research Studies. NMHA collects research studies
on the implementation of parity as well as cost analyses and other
research on the topic.
Please contact the Advocacy Resource Center if you are
interested in some of these more in depth studies.
Updated August 2005
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