This legislation, often called the Mental Health Parity bill, was tacked on to the $700 billion economic rescue plan as part of the add-ons needed to insure passage of the bailout.
Few dispute the impact the legislation will have. According to the National Institute of Mental Health, 26.2% of Americans over the age of 18 -- more than 58 million adults -- suffer from some type of mental illness.
In addition, figures from the National Institute on Alcohol Abuse and Alcoholism indicate that approximately 22 million Americans have an alcohol or drug abuse disorder.
When combined with evidence that many people who suffer from these conditions are denied sufficient access to care as a result of restrictions placed on their treatment by insurance companies and employers, these statistics raise even greater concerns.
Although there has been considerable debate over what constitutes benefit parity for those with mental illnesses and addiction disorders, for insurance companies and employers, containing the cost of treatment has been a major issue.
They've done that, typically, by financial restrictions or limitations on the number of days or visits for those seeking mental health benefits.
For example, before 1996 insurers set lower annual or lifetime limits on mental health illness coverage (e.g., $6,000) than on annual or lifetime limits on coverage for physical illnesses (e.g., $75,000). Carriers also established much higher co-payments for mental health outpatient visits (often 50%) than for outpatient visits for physical illness (typically 20%).
Underlying these policies was the belief that individuals are responsible for their own mental health and addictive disorders, and therefore are capable of changing these behaviors on their own.
But, the evidence base now shows that mental illnesses and addictive behaviors are diseases of the brain that can be caused by genetic mutations and that are responsive to newer treatments. With access to affordable care and appropriate treatment, individuals with mental illnesses or addictive disorders can function very well and make a greater contribution to society.
The new mental health parity bill was a long time coming.
The bipartisan measure was originally introduced in 1996 by Republican Senator Pete Domenici of New Mexico and Democratic Senator Paul Wellstone of Minnesota, both of whom have first-degree relatives with serious mental illnesses.
The bill passed in the Senate but not in the House. The compromise worked out in 1996 was a partial mental health parity bill that required insurers to pay the same amounts of money for mental illnesses and addiction disorders as for physical illnesses.
Believing that parity would raise their costs substantially, insurers responded by limiting the number of days covered for mental health hospitalizations (e.g., 20 days annually or lifetime) or the number of mental health outpatient visits (e.g., 30 visits annually or lifetime).
Senators Wellstone and Domenici attempted to pass legislation granting full parity across all health plans again in 2001. This time, they were joined by House members Patrick Kennedy (D-R.I.) and Jim Ramstad (R-Minn.) both of whom had battled addiction disorders themselves.
Although the House passed the bill in March 2008, it sat in the Senate until it became part of the $700 billion economic rescue plan. The bill's proponents stated that the bill will boost access for 113 million Americans, including 82 million people covered by self-insured plans and not assisted by state parity laws.
Senator Wellstone died in a plane crash in 2002 and did not see all of his hard work come to fruition.
This new law, which applies to group health plans and insurers who provide health coverage for 50 or more employees, builds on the foundation established by the mental health parity law of 1996, which stipulated that annual and lifetime limits must be equal for physical conditions and mental illnesses or addictive disorders.
Specifically the bill prohibits insurers and employers from reverting to their previous methods of limiting treatment for mental illnesses and addictive disorders.
The Congressional Budget Office (CBO) anticipates a modest increase in premiums, approximately two-tenths of 1 percent, for the parity bill.
The Federal Employee Health Benefits Program (FEHBP), which has provided coverage for mental health care to Members of Congress and 8.5 million other federal employees for the last eight years, has done so without a significant increase in cost as a result of parity for mental health benefits.
The reports from the CBO and the FEHBP should assuage concerns that the new law will spur large increases in premiums for health plans and insurers.
Most importantly, people seeking mental health services will have access to the treatments and services that will enable them to be more productive members of society.
Want More on Health Policy? â€¨Read David Nash's blog at http://departmentofhealthpolicy.blogspot.com.