May 7, 1999

Speaking one day prior to the introduction of a new parity bill he co-sponsored with New Mexico Sen. Pete Domenici (R), Sen. Paul Wellstone (D-Minn.) roused dozens of APA members who attended a luncheon at APA's biennial Federal Legislative Institute in Washington, D.C., last month.

In a speech interrupted repeatedly by applause, Wellstone thanked APA members and the Division of Government Relations for their efforts in promoting equitable mental health coverage. It was the critical testimony of people with mental illness and their families that made passage of the 1996 Mental Health Parity Act possible, he added.

"It was really all of the different organizations and all of the people who have been affected by mental illness, or whose loved ones have been affected by mental illness, who essentially said, 'We are men and women or parents of children of worth and dignity and substance, and we refuse to accept this discrimination any longer.' It was that voice nationwide and grass-roots lobbying that led to the passage of that piece of legislation."

That bill "was only partial parity," which equalized aggregate annual and lifetime limits on mental health coverage with other medical coverage, said Wellstone, "but the insurance industry has made an end run around that."

A recent analysis by the Hay Group revealed that copayments and deductibles had "gone way up, [and] employer coverage of mental illness had gone way down. There are even more restrictions on inpatient care, outpatient visits, so what has happened is that people don't reach any kind of limits in terms of lifetime or annual limits because people are being denied the treatment that they need," he added.

He summarized the new legislation, stressing the provisions for full parity for hospital days and outpatient visits as "the central feature" of the new bill.

"I will insist that this provision stay in, and I won't support any piece of legislation that does not have this provision," he said. He would "dearly love for the legislation to be stronger in certain ways, but this is a compromise between two senators." He praised Domenici for being "very gracious and very flexible."

Despite the bipartisan nature of the bill, Wellstone predicted major resistance from the insurance industry and said the fight for passage would be "a major, major battle." But he added, "We've got a fighting chance to win this one-I think it would be a huge step forward."

He called on APA to "help put together a great citizen lobbying effort." If successful, said Wellstone, "we won't have taken the full journey" but it will be "historically significant reform" that could improve the lives of many Americans and end some of the blatant discrimination against the mentally ill.

A Substance Abuse and Mental Health Services Administration (SAMHSA) study published last year projected a 3.7 percent increase in insurance premiums in the hypothetical case of federally mandated full parity for both mental health and substance abuse coverage, Wellstone observed. "Clearly we could do it, the costs are low, and the costs of not treating people-I don't need to tell you-are high."

The SAMHSA study can be found on the Internet at http://ww.samhsa.gov/press/980324.htm.