At a press conference on Capitol Hill on April 14, Senators Pete Domenici (R-NM) and Senator Paul Wellstone (D-MN) announced the introduction of S. 796, the Mental Health Equitable Treatment Act of 1999 (MHETA), a bill that ends insurance discrimination against people with serious brain disorders and their families. The Senators were joined by Senator John Chafee (R-RI) who is a primary cosponsor of this historic legislation. There are now four other Senate cosponsors: Senators Arlen Specter (R-PA), Harry Reid (D-NV), Edward Kennedy (D-MA), and Paul Sarbanes (D-MD), which reflects strong bipartisan support. S. 796 firmly states that severe mental illnesses are biologically based illnesses of the brain and should be treated like any other medical illness. The bill provides for full insurance parity for the most severe, biologically based mental illnesses by prohibiting unequal restrictions on annual and lifetime mental health benefits, inpatient hospital days and outpatient visits, and out-of-pocket expenses.

ACTION REQUESTED

All NAMI members and activists are encouraged to begin an enduring grassroots action campaign to obtain support for this important legislation. Please contact your senators and urge them to cosponsor S. 796, the Mental Health Equitable Treatment Act of 1999, to provide full parity and end unjust insurance discrimination against people with severe mental illnesses and their families. All Senators can be reached by calling the Capitol Switchboard at 202-224-3121. Fax numbers, mail and email addresses can be obtained by accessing the NAMI website at www.nami.org/policy.htm and click on Write to Congress.

An all out effort is needed to ensure that full parity will pass and benefit millions of Americans who are currently denied access to treatment through discriminatory limits on their coverage. Members of Congress need to hear from consumers and their families throughout the country and be educated on the hardships they face. Please contact Andrew Sperling, Andrew@nami.org or Chris Marshall, Chris@nami.org at the NAMI office for assistance.

PRESS CONFERENCE

Senators Domenici and Wellstone invited NAMI members Peg and Marian Danowski to speak at the press conference to share their family story that illustrates the devastating consequences of unfair insurance practices against families caring for a loved one with severe mental illness. Holding an enlarged photograph of their son, the Danowski’s presented a compelling and moving portrayal of the suffering their family and son have endured due to discriminatory insurance policies that have denied access to essential care for their son and put them into financial duress.

NAMI Board member Jim McNulty also spoke at the press conference reinforcing the need for equitable insurance benefits and just practices. He referred to his own experience of not being able to access effective treatment due to a lack of insurance coverage. McNulty pledged NAMI’s solid support for this landmark legislation.

SUMMARY OF THE BILL

The Mental Health Equitable Treatment Act of 1999, bill number S. 796, builds greatly on existing legislation, the Mental Health Parity Act of 1996, which equated annual and lifetime limits for mental health benefits with limits for medical/surgical benefits. MHETA requires that limitations on the coverage of benefits for "severe biologically-based mental illnesses" may not be imposed unless comparable limitations are imposed on medical and surgical benefits. This provision provides full insurance parity for treatment for people with severe mental illnesses and effectively removes all inequitable limits including on copays and deductibles, and on inpatient days and outpatient days.

The legislation targets specific adult and childhood mental illnesses and defines the term "severe biologically-based mental illnesses" as illnesses determined by medical science in conjunction with the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) to be severe and biologically-based. These illnesses are:

• schizophrenia
• bipolar disorder (or manic depression)
• major depression
• obssessive compulsive disorder
• panic disorder
• posttraumatic stress disorder
• autism
• and other severe and disabling mental disorders such as anorexia nervosa and attention deficit/hyper activity disorder.

MHETA also prohibits unequal limits on the number of covered inpatient days and outpatient visits for people seeking treatment for all mental illnesses. The amount of covered impatient days and outpatient visits for mental illnesses must be equated with covered medical/surgical inpatient days and outpatient visits.

MHETA contains a small business exemption that improves upon the existing law which has an exemption for employers with more than 50 employees. The new bill provides an exemption for employers with 25 or fewer employees, thus widely extending the reach of the parity provisions.

Finally, passage of S. 796 would effectively remove the current sunset provision on the Mental Health Parity Act that stated that the law was effective until September 30, 2001. Also, MHETA does not contain the one percent cost exemption currently in the Mental Health Parity Act that allows employers to exempt themselves if they can demonstrate that their premium costs rose by more than one percent due to the implementation of parity.

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