The fact that Congressand perhaps the presidentare closer than ever to a mental-health parity statute doesnt mean care shouldnt be taken with the final legislation. A bill working its way through the House is far preferable to a Senate bill, which fails to adequately define a sufficient level of coverage, and contains too many avenues for crafty insurers to bob and weave past legislative intent.
For those who dont follow this issue closely, an 11-year-old federal law that was supposed to guarantee that insurers treated mental health conditions the same as physical illnesses has proved inadequate. Loopholes allowed insurers to charge higher deductibles and limit physician visits for psychiatric conditions. Some 46 states have adopted some form of parity laws, though many of those dont provide broad coverage for all mental illnesses. And self-funded health insurance plans, mainly employer-sponsored coverage, are exempt from state regulation under the federal Employee Retirement Income Security Act.
The reason for mental-health parity is obvious; people with illnesses ranging from substance abuse to bipolar disorder find their coverage is so modest and the out-of-pocket payments so high that they go bankrupt paying for their care. And mental illness is just like any other illness in its effects on patients and their ability to function in the world.
Thankfully, the Senate dropped its earlier insistence on total pre-emption of state parity laws. But the bill was carefully crafted to win the support of big business and the large health insurers, which for years battled against any notion of a parity law.