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Parity bill’s
fate likely to be decided in September
(August/September
2008 Issue)
By Ami Albernaz
Following intense negotiations, the U.S. House and Senate have
come to an agreement on mental health parity legislation. If approved
by the White House, it would mark the end of a more-than-a-decade
long struggle to mandate equal treatment for physical and psychological
ailments by insurance companies.
Although the Senate and House parity bills shared the same goal,
they differed on some key points. The Senate bill, which passed
last September, was more palatable to business and insurance organizations,
which feared an increase in costs under the parity law.
The compromise exempts businesses with fewer than 50 employees,
the Wall Street Journal reported. The compromise includes the House
provision that out-of-network mental health and substance use disorder
services be provided at parity when a plan provides out-of-network
physical health services. It also requires plans to disclose their
medical necessity criteria and to provide reasons for denials of
coverage. States with parity laws stronger than the federal bill
would have those laws preserved, while state laws weaker than the
new federal bill would be superseded. The compromise does not require
insurers to cover mental health and addiction services; rather,
it governs the practices of those that do.
The bill, which would affect around 70 percent of Americans with
employer-provided insurance, is expected to raise monthly premiums
slightly, while offering significant cost savings for those who
use mental health services. Premiums for group health insurance
would increase by an average of 0.4 percent under a parity law,
the Congressional Budget Office estimated.
The bill would cost the government roughly $3.4 billion over the
next decade, says Doug Walter, J.D., legislative and regulatory
council for the APA Practice Organization. (That cost would result
from lower taxable wages because of higher insurance premiums).
Under Congressional rules, offsets for the bill's cost must be found
before it can be brought back to the House and Senate floors for
a vote. It appears that some financing options have already been
found, Walter says, and that it will be brought back to both chambers
in the fall.
"There are avid sponsors in the House and Senate, so even in a
[legislatively] crowded September, I think it has a good chance
of being passed," Walter says. "It's going to provide comprehensive
coverage for mental health. We don't see any loopholes in the legislation…
It's really an historic marker for mental health."
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