Arrow-right Camera
The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Business Fights Mental Health Provision In Bill Firms Would Have To Provide Equal Coverage For Mental, Physical Illness

Edwin Chen And Robert A. Rosenblatt Los Angeles Times

A proposal to dramatically expand health insurance coverage for mental illness is drawing fierce opposition from business and threatens to kill the popular health reform legislation now moving through Congress.

The Senate is scheduled to vote today on final passage of a bill making it easier for millions of Americans to keep their coverage if they quit their jobs, are laid off, or suffer from a serious illness.

But the popular legislation came under attack from business Monday with warnings that the mental health provision could sink the entire bill. Up to now there was no serious opposition to the bill, but business has been successful in the past in killing any health care legislation it found unacceptable.

The provision would mandate that corporate health plans provide the same level of benefits for mental illness as they provide for physical ailments.

Critics say the mandate would cause a sharp and unsustainable increase in health care spending. Current health insurance programs provide much more restricted coverage for mental health treatment. Proponents of parity for mental health coverage, including Tipper Gore, wife of the vice president and the administration’s foremost advocate on the issue, say such coverage is not only a question of fairness but also can reduce costs associated with worker productivity.

In an interview Monday, Tipper Gore said she “will continue working hard, make no mistake about it, to promote parity for mental health.”

“Treatment not only saves lives; it saves dollars,” added Sen. Paul Wellstone, D-Minn., one of the provision’s sponsors.

The vast majority of companies with more than 500 workers have unlimited freedom to set the terms and conditions of their health insurance coverage. The amendment adopted by the Senate last Thursday on a 68-30 vote would impose a new federal mandate, insisting on parity in mental health coverage for any company offering health insurance to its workers.

But critics warned Monday the provision could doom the legislation.

Mental health coverage “is a very expensive benefit,” said Laura Thevenot, vice president for federal affairs at the Health Insurance Association of America, a highly influential industry trade group. “We obviously have a concern with anything that will increase the cost of coverage,” she said.

“It is extremely difficult for the chamber to imagine a compromise that would make this acceptable,” Neil Trautwein, manager of health care policy for the U.S. Chamber of Commerce, said Monday. The burden of covering mental health ailments can be “a bottomless pit, cost-wise,” he said.

The mental health coverage changes would significantly increase costs, leading to a further decline in coverage, said Richard Smith, vice president for health care policy at the Association of Private Pension and Welfare Plans, which represents major U.S. corporations. He said costs could climb 8 percent to 11 percent.

The mandate was added to the insurance reform measure during an unusually personal and poignant Senate debate in which members recalled the devastation of loved ones by mental illness.

Sen. Alan Simpson, R-Wyo., detailed the mental illness that gradually overtook a niece so that one day she bought a gun, went to an isolated field and “blew her chest away.”

The lead Republican sponsor, Sen. Pete V. Domenici of New Mexico spoke movingly of his daughter, who receives mental health treatments. Insufficient insurance coverage for mental health “represents one of the real continuing injustices in America today,” Domenici said during the debate. Costs would increase less than 2 percent if his amendment becomes law, according to Domenici.

Wellstone, his co-sponsor on the Democratic side, talked about his brother who suffers from mental illness.

Domenici, a conservative, and Wellstone, a liberal, formed an informal “working group on mental health” several years ago, and that coterie has increased to 35 senators.

“Everybody in this group has a loved one or a friend with mental illness,” Wellstone said.

Among the Senate’s 100 members - a much more cohesive group than the 435-member House - personal relationships and private appeals carry a lot of weight.

During last week’s debate, Wellstone recalled on Monday, many members approached him or Domenici and said words to the effect: “This is very personal to you, isn’t it? I’m going to vote with you.”

The vote “transcended typical politics and parties,” he said.