The long-held dream of parity in behavioral healthcare is now a reality: The U.S. House of Representatives voted 263-171 to approve the Wall Street bailout bill, which includes a provision that mandates parity coverage for addiction and mental-health care, and President George Bush swiftly signed the measure into law.
The House vote came just days after the Senate passed an identical bill on a 74-25 vote. Earlier, the House had rejected a bill that called for a $700-billion bailout of the financial system but did not include the parity provision.
"This legislation is one more step in the long civil-rights struggle to ensure that all Americans have the opportunity to reach their potential," said Rep. Patrick Kennedy (D-R.I.), who cosponsored the House bill with Rep. Jim Ramstad (R-Minn.). "For far too long, health insurance companies have used the stigma of mental illness and substance abuse as an excuse to deny coverage for those biological disorders. That ends today when this critical legislation outlaws the discrimination that is embedded in our laws and our policies."
The parity bill does not require health-insurance plans to cover addiction or mental health, but insurers will now be barred from imposing any caps or limits on behavioral healthcare service that are not applied to other health conditions. Most insurance plans do include behavioral-healthcare coverage, and advocates say that past experience shows that passage of state-level parity laws has not led to insurers dropping such coverage.
Kennedy praised addiction and mental-health advocacy groups "and the individuals who wrote letters and made calls, for their unyielding support and grassroots efforts to build support [for the parity bill] among their individual House and Senate members."
"This was a team effort which worked to build support for mental-health parity legislation over the long haul, and all the hard work paid off today," he said.
The Senate parity bill was sponsored by Sens. Edward Kennedy (D-Mass.), Chris Dodd (D-Conn.), and Pete Domenici (R-N.M.). "No longer will we allow mental health to be treated as a stepchild in the healthcare system," said Domenici.
Now known as the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, the legislation that passed both houses of Congress this week is the historic culmination of a battle for equal coverage of addiction and mental illness that stretches back more than a decade, and helped to spark the growth of the recovery-advocacy movement.
Wellstone's son, David, called the bill "a major achievement, one I know my dad would be proud of." Paul Wellstone, an early supporter of parity, died in a 2002 plane crash along with his wife, Sheila, and daughter, Marcia, while campaigning for reelection.
"This bill will go a long way to ease the pain and suffering of those with mental illness and addiction, and I am proud to have been part of this effort. It's a great day," said David Wellstone, cofounder with his brother, Mark, of Wellstone Action, which has advocated on behalf of the parity bill.
"[The] vote today ensures that people, and their families, who face mental health and addiction diseases can be afforded the opportunity to get well and live a life of recovery," added Missy Orlando, executive vice president of corporate planning and communications for Caron Treatment Centers of Wernersville, Pa.
Pat Taylor, executive director of the advocacy group Faces and Voices of Recovery, said that a series of public hearings sponsored by Kennedy and Ramstad helped shed light on the problem of insurance discrimination against people in recovery and build support for parity legislation. "This victory turns the page in how our nation responds to our leading health problem -- addiction to alcohol and other drugs," said Taylor. "While nearly half of Americans know someone who is in recovery alcohol or drug problems, over 22 million Americans still struggle and have yet to find new lives in recovery; the Wellstone-Domenici bill will help pave their ways."
"I am glad to have lived to see the day that alcohol and drug addiction treatment will be provided like that of any other chronic illness," said John Hulick, director of public affairs and policy for NCADD New Jersey. "We look forward to redoubling our efforts in New Jersey to build on the new floor for addiction treatment established by today's passage of the federal parity legislation."
The road to passage of the parity bill in the current Congress included the House and Senate passing divergent versions of the measure this spring, followed by sponsors and Congressional leaders coming together over the summer to craft a consensus version of the legislation. In late September, the House of Representatives passed a standalone version of the bill, while the Senate attached the measure to a bill intended to extend tax breaks for alternative-energy projects.
Ultimately, advocates in both houses of Congress decided that the best way to get the legislation passed was to attach it to the bailout bill, the single most critical measure under consideration before Congress goes into recess ahead of the November elections.
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