Congressional Negotiators Hitting Roadblocks On Mental Health Parity Legislation

Main Category: Mental Health
Article Date: 21 Nov 2007 - 8:00 PDT

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Sponsors of the House and Senate versions of legislation (HR 1424 and S 558) that would require most health insurers to provide equal levels of coverage for physical and mental illnesses are "bumping up against" conflicts in negotiations that could "thwart" the bill's passage this year, CongressDaily reports. Over the last month, House sponsors Patrick Kennedy (D-R.I.) and Jim Ramstad (R-Minn.) have met with Senate sponsors Pete Domenici (R-N.M.) and Edward Kennedy (D-Mass.) to discuss possible compromises. "We are at a delicate point in the negotiations," Ramstad said (Johnson, CongressDaily, 11/19).

The House bill includes provisions not included in the Senate legislation, including a broader definition of medical conditions that insurers would have to cover. In addition, the Senate bill would take effect one year after the legislation becomes law, while the House bill would be implemented Jan. 1, 2008 (Kaiser Daily Health Policy Report, 10/17).

Domenici said that the talks have been difficult. He added, "The discussion has centered around the fact we cannot modify this bill and get it through the Senate unless the modifications have no consequence, in which event, why would they want them? They know that, and I think they believe us." Lawmakers also are facing challenges in determining where to find the $4 billion in costs associated with the House bill to comply with pay/go rules. The House bill cleared three committees, "all of which are expected to help find the money," but the House Ways and Means Committee "might be asked to carry the heaviest load," CongressDaily reports.

However, the Ways and Means Committee "might use its health-related revenue raisers to offset" a scheduled cut for physicians under Medicare, rather than funding the mental health parity legislation, according to CongressDaily. Lawmakers could offset some cost by delaying the effective date of the mental health bill. The Senate bill did not identify offsets. Any changes agreed on by the lawmakers could be added as a manager's amendment to the House bill before it reaches the floor (CongressDaily, 11/19).

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