President Bush last week walked a fine line when he voiced his support for mental health parity without endorsing proposed legislation.
"Our health insurance system must treat serious mental illness like any other disease," Bush said at an appearance in Albuquerque with Sen. Pete Domenici (R-N.M.).
Domenici and Sen. Paul Wellstone (D-Minn.) introduced legislation in July 2001 that would require insurers to cover all mental health disorders to the same extent they do medical and surgical benefits. The Republican-led House has blocked the bill.
"Health plans should not be allowed to apply unfair treatment limitations or financial requirements on mental health benefits," Bush said.
However, Bush did not specify his goals beyond saying he would work with Congress to reach an agreement this year and emphasized it was important to "not significantly run up the cost of healthcare."
Both psychiatric and acute-care hospitals eat the costs when a patient's benefits run out. Hospitals support the Domenici-Wellstone bill, which would provide full parity in treatment limits and cost sharing for all categories of mental health conditions.
The 1996 parity law does not prevent insurers from setting different annual and lifetime benefits as well as copayments for mental illnesses than for physical illnesses. The law expired last October, but Congress reauthorized it for a year last December, after the House rejected the Domenici-Wellstone proposal, which was attached to a budget bill and approved by the Senate.
Mental health organizations and hospital groups praised the president's interest in mental health and campaigned for the Domenici-Wellstone bill last week.
Members of the Coalition for Fairness in Mental Illness Coverage, which includes the American Hospital Association, the Federation of American Hospitals and other providers, said the president's comments have moved their issue ahead. "The president clearly has moved the ball forward, and the House leadership is now looking at it as a real live issue-one they will have to deal with this year," said Mark Coval, executive director of the National Association of Psychiatric Health Systems.
He predicted the bill would encourage more patients to seek mental healthcare and would spark investors' interest in mental health.
Health insurers and business groups attacked the bill but not the president.
Karen Ignagni, president and chief executive officer of the American Association of Health Plans, questioned mandates on mental health when 40 million Americans lack access to overall health insurance.
More than 90% of employers already provide mental health coverage for significant conditions, said Donald Young, M.D., president of the Health Insurance Association of America. "At a time when health costs are soaring, the last thing employers and workers need is a new mandate that will make health insurance even more expensive," he said.
In his remarks, Bush also announced a one-year mental health commission to be led by Ohio's mental health director, Michael Hogan. The commission is charged with making recommendations for tightening the gap in mental health coverage.