One more party-line vote by the GOP to continue the discrimination in insurance against those with mental illness.
-- Nathan Newman
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New York Times December 19, 2001 Drive for More Mental Health Coverage Fails in Congress By ROBERT PEAR
ASHINGTON, Dec. 18 - A bid to give millions of Americans greater access to mental health care died in Congress tonight as House members rejected a Senate proposal to eliminate disparities in insurance coverage for mental and physical illnesses.
The action followed 45 minutes of impassioned debate over the rights of people with mental disorders. "This is one of the most important social and civil rights issues in the United States," said Senator Pete V. Domenici, Republican of New Mexico, who had offered the proposal approved by the Senate in October.
Mr. Domenici, who has a daughter with schizophrenia, and Senator Paul Wellstone, Democrat of Minnesota, whose brother has severe mental illness, pleaded with House members to outlaw the widespread limits on treatment for psychiatric disorders.
But at a meeting of House and Senate negotiators, the House members rejected the Senate proposal by a party-line vote of 10 to 7. The House Republicans all voted no. The House Democrats all voted yes.
Mr. Domenici and Mr. Wellstone said they wanted to require health plans and insurance companies to provide equivalent coverage, or parity, for mental and physical illnesses.
House Republicans, employers and insurance companies objected to the proposal, saying it would increase costs for employers in a recession, when many businesses are already cutting health benefits because of a resurgence in medical inflation.
The Senate had required "mental health parity" in an amendment to the annual spending bill for the Departments of Health and Human Services, Education and Labor. Mr. Domenici, Mr. Wellstone and their supporters, including the American Medical Association and the National Alliance for the Mentally Ill, vowed to continue their efforts next year.
"We let insurance companies operate on the ridiculous presumption that people with schizophrenia are not sick," Mr. Domenici told members of the House-Senate conference committee. "I am begging you to use your influence to get a vote on this issue in the House."
Democrats described the question as a moral issue. "This amendment is directed against injustice," said David R. Obey of Wisconsin, the senior Democrat on the House Appropriations Committee. Representative Patrick J. Kennedy, Democrat of Rhode Island, said, "If we pass this amendment, we save lives." Representative Nancy Pelosi, Democrat of California, said, "This issue is a challenge to the conscience of this committee and Congress."
But Representative Anne M. Northup, Republican of Kentucky, said the Senate proposal would force insurers to increase premiums, co- payments and other charges. "Insurance companies won't take in $1 million worth of premiums and pay out $2 million worth of benefits," Ms. Northup said.
Powerful House Republicans, including Speaker J. Dennis Hastert of Illinois and three committee chairmen, said the appropriations bill was not a proper vehicle for setting national policy on health benefits.
President Bush steered clear of the fight. In a letter to Senator Domenici, Mr. Bush said he wanted to "reduce the stigma of mental illness," and he noted that, as governor of Texas, he had signed a bill to reduce disparities in coverage of mental and physical illnesses.
But Mr. Bush said he had concerns about the effects of the Domenici- Wellstone bill on "employers' ability to provide benefits and coverage, particularly during a time of economic recession and rapidly rising health care costs." In particular, Mr. Bush said, "I am concerned that employers may scale back health benefits or that individuals will lose coverage because they cannot afford the premium increases that are expected for next year."
Mr. Bush said he would work with Congress next year to devise "a solution" that reduced disparities in insurance coverage without significantly increasing health costs.
At present, people who are treated for mental illnesses like schizophrenia or depression often face higher co-payments and deductibles than they would pay for the treatment of physical ailments, like diabetes or cancer. Likewise, many insurance plans cover fewer visits to a doctor, and fewer days in a hospital, when the patient has a mental illness.
The appropriations bill, which is expected to win quick approval from both houses of Congress and Mr. Bush later this week, provides a total of $123.8 billion, up 11 percent.
The bill would increase the budget of the National Institutes of Health by nearly 15 percent, to $23.3 billion in the current fiscal year, which began on Sept. 1, up from $20.3 billion.
Congress is in the fourth year of a bipartisan effort to double the budget of the N.I.H., which had a budget of $13.6 billion in 1998. But the agency has been without a presidentially appointed director since Dr. Harold E. Varmus left in December 1999.