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Mental health groups make push for parity

WASHINGTON (AP) — Many people battling addiction or suffering from mental health problems could get better health insurance coverage under legislation that has widespread, bipartisan support but still faces some hurdles before getting to President Bush for his signature.

Patients seeking treatment for depression or schizophrenia often face greater restrictions with their health insurance coverage than do patients getting treatment for heart disease or diabetes. For example, they sometimes have to pay more money out of pocket before their insurance will kick in. Also, insurers sometimes cover fewer visits for mental health treatments than they will for someone getting care for physical ailments.

Both the House and the Senate passed legislation on Tuesday that would prevent group health plans with 51 or more employees from imposing such unequal standards.

The legislation does not mandate that group health plans cover mental health or addiction treatment, only that when plans do so, the coverage must be equitable to other medical coverage.

Reps. Patrick Kennedy, D-Rhode Island, and Jim Ramstad, R-Minnesota, led efforts to pass the bill in the House.

"I am alive and sober today only because of the access that I had to treatment following my last alcoholic blackout on July 31, 1981," Ramstad said before the House passed the bill 376-47.

"I woke up that day in a jail cell in Sioux Falls, South Dakota, and I am living proof that treatment works and recovery is possible. But far too many people in our country don't have the same access to treatment that I and other members of Congress, other federal employees have."

Kennedy has said his own personal struggles to recover from depression, alcoholism and substance abuse have made him a more compelling advocate in Congress for improved mental health care coverage.

While the House bill focused strictly on mental health parity, the Senate bill also covered the renewal of dozens of popular tax breaks for businesses and individuals. The two chambers will have to pass an exact, final version before it can become law, but time is quickly passing for this Congress.

"The will is there in both the House and Senate to get this done," assured Brendan Daly, spokesman for House Speaker Nancy Pelosi.

The projected cost of the measure to the federal government is about $3.4 billion over 10 years as private companies are expected to deduct more health expenses from federal income taxes.

Andrew Sperling, director of legislative advocacy for the National Alliance on Mental Illness, said mental health treatment has often been treated as a separate benefit because insurers and their contractors had less familiarity in dealing with psychiatric hospitals, psychiatrists and other mental health providers.

"It's a world they don't know," Sperling said. "We've made advances in scientific discovery and treatment, so the excuse of less certainty about treatment and outcomes, I think we've gotten past that."

In the end, the higher deductibles, co-payments and the caps on number of visits prevented people with mental health problems from getting help, Sperling said. When families exhausted their coverage after 18 or 24 months, they were left to deal with the problem on their own or through programmes such as Medicaid.