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Mental Health Liaison Group
Action Alert

Date: November 8, 2001
To: MHLG Members and Observers
Parity Supporters
From: Peter Newbould, Health Policy Committee Cochair, 202-336-5889
Chris Koyanagi, Health Policy Committee Cochair, 202-467-5730 x18
Re: Conference Strategy for Mental Health Parity
Pages: 5

Senate-Passed Mental Health Parity Moves to Conference
Aggressive Grassroots Campaign Needed to Win Enactment

The campaign for mental health parity moves to a more challenging arena after Senate approval Oct. 30 of S. 543, the Mental Health Equitable Treatment Act, as an amendment to the FY 2002 Labor-HHS-Education Appropriations bill (H.R. 3061). A conference committee of House and Senate appropriators charged with resolving the differences in the two bodies' Labor-HHS-Education funding bills will provide the forum for deliberations on mental health parity. The success of Senators Domenici and Wellstone in attaching parity to an appropriations bill now brings additional players into deciding the fate of mental health parity. In the face of likely House opposition to expanding parity beyond the partial protections in the Mental Health Parity Act of 1996, grassroots efforts will be critical to success.

Action: By COB on Wednesday, November 14, constituents of targeted House members should use the toll-free parity "legislative hotline" at 1-866-PARITY4 (1-866-727-4894) to reach the Capitol Switchboard and ask for their Representative's office by name or caller's home ZIP code. When connected, ask for the health legislative assistant and deliver the message below. The conference may end as soon as November 16!

Targets (See names below):
++ Members of the House Appropriations Committee to urge them to accept the Senate parity amendment.
++ The chairman and ranking Democratic member of these House committees (full committee and relevant subcommittees): Education and Workforce, Energy and Commerce, and Ways and Means to urge them to work with Appropriations conferees to accept the Senate parity amendment.
++ Other Representatives should be urged to cosponsor H.R. 162 if they have not already. Here is a link to the cosponsor list: http://thomas.loc.gov/cgi-bin/bdquery/z?d107:HR00162:@@@P

Message: "I'm calling to urge the Representative to work with Labor-HHS Appropriations conferees to accept the Senate's mental health parity amendment. This legislation will help families by banning arbitrary limits on needed mental health services."

Background: Labor-HHS Appropriations Subcommittee members will be the conferees, but other House members will also play important behind-the-scenes roles in deliberations on mental health parity. Three different committees of the House have jurisdiction over elements of mental health parity legislation. They are the Committee on Education and the Workforce, the Committee on Energy and Commerce and the Committee on Ways and Means. Those authorization committees are likely to be consulted as to their views on parity. The effort to legislate on an appropriations bill is unorthodox (though hardly unprecedented), but it is important to note that none of the three committees acted on the House parity bill, H.R. 162.

House Bill: The House full parity bill, the Mental Health and Substance Abuse Parity Amendments, (H.R. 162, Roukema), currently has 179 cosponsors, 24 of whom are Republican. It is critical that we work to have more House members cosponsor that bill to signal what we believe should be overwhelming support in the House for enactment of mental health parity.

Fact Sheet: Attached is a fact sheet prepared by the Coalition for Fairness in Mental Illness Coverage summarizing our parity position. Six more parity fact sheets are posted at www.mhlg.org/page4.html.

Targets, With Cosponsors of H.R. 162 Marked:
Alabama: Callahan (R); Aderholt (R); Cramer (D) Cosponsor
Arizona: Kolbe (R) Cosponsor; Pastor (D) Cosponsor
California: Cunningham (R); Farr (D) Cosponsor; Doolittle (R); Lewis (R); Pelosi (D) Cosponsor; Roybal-Allard (D) Cosponsor. Miller (D) Education & Workforce Ranking Democrat; Thomas (R) Ways & Means Chairman; Stark (D) Cosponsor/Ways & Means Sbcmte Ranking Democrat
Connecticut: DeLauro (D) Cosponsor
Florida: Bill Young (R) Approp Cmte Chairman; Dan Miller (R); Boyd (D); Meek (D)
Georgia: Kingston (R)
Illinois: Jackson (D) Cosponsor; LaHood (R)
Indiana: Visclosky (D) Cosponsor
Iowa: Latham (R)
Kansas: Tiahrt (R)
Kentucky: Northup (R); Rogers (R)
Louisiana: Vitter (R). Tauzin (R) Commerce Chairman
Maryland: Hoyer (D) Cosponsor
Massachusetts: Olver (D) Cosponsor
Michigan: Knollenberg (R); Kilpatrick (D) Cosponsor. Dingell (D) Commerce Ranking Democrat
Minnesota: Sabo (D)
Mississippi: Wicker (R)
Missouri: Emerson (R)
New Hampshire: Sununu (R)
New Jersey: Frelinghuysen (R) Cosponsor; Rothman (D). Andrews (D) Cosponsor/Education & Workforce Sbcmte Ranking Democrat.
New Mexico: Skeen (R)
New York: Lowey (D) Cosponsor; Hinchey (D) Cosponsor; Serrano (D) Cosponsor; Sweeney (R); Walsh (R) Cosponsor. Rangel (D) Ways & Means Ranking Democrat
North Carolina: Price (D) Cosponsor; Taylor (R)
Ohio: Regula (R) Approp Sbcmte Chairman; Hobson (R); Kaptur (D) Cosponsor. Boehner (R) Education & Workforce Chairman; S. Brown (D) Cosponsor/Commerce Sbcmte Ranking Democrat.
Oklahoma: Istook (R)
Pennsylvania: Peterson (R); Sherwood (R); Fattah (D); Murtha (D);
Rhode Island: P. Kennedy (D) Cosponsor
South Carolina: Clyburn (D) Cosponsor
Tennessee: Wamp (R)
Texas: Granger (R); Bonilla (R) Cosponsor; DeLay (R); Edwards (D)
Virginia: Goode (I); Moran (D) Cosponsor; Wolf (R)
Washington: Dicks (D); Nethercutt (R)
West Virginia: Mollohan (D) Cosponsor
Wisconsin: Obey (D) Approp Cmte Ranking Democrat

Coalition for Fairness in Mental Illness
Coverage
_________________________________

PASS MENTAL HEALTH PARITY NOW!
END DISCRIMINATORY MENTAL HEALTH COVERAGE

No matter the form, discrimination is wrong. Yet, mentally ill patients seeking treatment are discriminated against by requiring higher copayments, allowing fewer doctor visits or days in the hospital, or higher deductibles than imposed on other medical illnesses. This discrimination results from outdated misconceptions and the stigma surrounding mental illnesses. If left to continue, the financial and human costs of untreated mental illness will far exceed the costs purported by opponents - that covering mental health services will exponentially and unfairly increase premiums for all enrollees. In fact, data have shown that the cost of instituting equal coverage for treatment of mental illnesses is inconsequential.

The Mental Health Parity Act (MHPA) of 1996 will sunset on September 30, 2001. This current federal law prohibits discriminatory annual and lifetime dollar caps for mental health benefits as compared to medical and surgical benefits. The Act has had a minimal cost, but 87% of complying health plans have evaded the spirit of the law by replacing dollar limits with arbitrary limits on inpatient days and outpatient visits or another part of the benefit, found the U.S. General Accounting Office (May 2000).

The Mentally Ill Population
According to the Surgeon's General Report on Mental Health, about 20 percent of the U.S. population are affected by mental disorders during a given year.
· About 20 percent of children are estimated to have mental disorders with at least mild functional impairment. Over 50 million adults suffer from mental or substance abuse disorders on an annual basis.

· The National Institute of Mental Health has shown that success rates of treatment for disorders such as schizophrenia (60%), depression (70-80%) and panic disorder (70-90%) surpass those of other medical conditions (heart disease, for example, has a treatment success rate of 45-50%).

Parity in Mental Illness Coverage Can Save Money
Providing equal coverage for all illnesses makes good economic sense; when mental illnesses go untreated, costs begin to escalate.
· The National Institute of Mental Health estimates that the annual cost of untreated mental illnesses exceeds $300 billion, primarily due to productivity losses (missed days of work and premature death) of $150 billion, health care costs of $70 billion, and societal costs (increased use of the criminal justice system and social welfare benefits) of $80 billion.

· An MIT Sloan School of Management report showed in 1995 that clinical depression costs American businesses $28.8 billion a year in lost productivity and worker absenteeism.

Providing Parity for Mental Illness is Affordable

A growing body of research and actual industry experiences indicate that parity can be implemented without substantially increasing premiums.

· The National Mental Health Advisory Council, in its 2000 final report to Congress, estimates an approximate 1.4% increase in total health insurance premium costs when parity is implemented.

· Since implementation of North Carolina's state employees' parity law in 1992, mental health payments as a portion of total health payments decreased from 6.4% to 3.4% in FY 1996. This represents a 47% reduction in costs. During the same time period, there was a 64% reduction in hospital days paid by the State Employees Health Plan for mental illness (NC State Health Plan Office).

Why Do We Need Mental Health Parity Legislation Enacted into Law?

· The enactment of the Mental Health Parity Act of 1996 (P.L. 104-204) was the first step in ending the discrimination against individuals with mental illnesses. However, the fight is far from over. The federal law is limited in scope and application: the federal law only applies to mental health annual or lifetime cost limits, but not to substance abuse, copayments, deductibles, or inpatient/outpatient treatment limits.

· Beginning January 1, 2001, the Federal Employees Health Benefit Program (FEHBP) implemented full parity benefits to its 9 million beneficiaries.

· At the federal level, Senators Pete Domenici (R-NM) and Paul Wellstone (D-MN) introduced the Mental Health Equitable Treatment Act of 2001, S. 543. This legislation mirrors the already existing FEHBP parity benefit by proposing to expand on existing law by addressing limits on deductibles, coinsurance, co-payments, other cost sharing, and limitations on the total amount that may be paid with respect to benefits under the plan or health insurance coverage. Representative Marge Roukema (R-NJ) introduced the Mental Health and Substance Abuse Parity Amendments of 2001, H.R. 162. The bill proposes to extend full parity to those who are covered by mental health or substance abuse plans. It is clear there is congressional support for extending and building upon the 1996 law.

Discrimination, whatever the form, is WRONG. Mental illness is just like any other medical illness; treatment is successful and cost effective. The passage of mental health parity legislation will help end benefit discrimination that currently exists against people with mental illness.