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Where are Obama, Clinton on Mental Health Parity Reconciliation Effort?

Posted by JILL MILLER ZIMON in Health, Politics.
Mar 6th, 2008 | Comments

From WebMD:

The House passed a broad bill guaranteeing better mental health coverage for people with private insurance Wednesday, handing a victory to patient and medical groups that championed the bill.

…
Many mental health patient groups and medical societies have long fought for the bill. Congress has tried and failed to pass similar legislation for more than a decade. Some groups, including the National Alliance for the Mentally Ill, backed the Senate version, saying it was more likely to be signed into law.

…

Many of those same groups remain skeptical that Wednesday’s bill can be reconciled with a significantly weaker version that passed the Senate late last year.

That bill allows insurers to choose which mental illnesses to cover. It also would negate potentially stronger state parity laws. Forty-two states have some form of parity on their books now.

Several conservative senators have already threatened to block the House and Senate from meeting to reconcile the two bills.

Anyone have the list of the senators who have threatened to block the meeting to reconcile? I’d say that the ones who don’t want to meet are probably the ones who need the most mental health help, but that would be too out of character for me.

Senators Hillary Clinton and Barack Obama were co-sponsors of S. 558, but I’d like to know their positions on pushing for reconciliation. Given the focus on their dueling universal health care coverage plans during the last few months, mental health parity is a piece that must be considered by them as they continue to campaign.

The Bush Administration opposes the House version.

The Senate version is S. 558. The House version is HR 1424.

  • Pete Abel
    I'm not sure where the Dem prez candidates are on this subject, but interestingly enough, last year -- and I assume it's still true -- the House version is the passion of Rep. Patrick Kennedy (D-RI), with whose office I've worked to support that version; while the Senate version is backed by none other than Patrick's pop, Ted Kennedy. The argument I've heard is that if we parity supporters want Congress to do something, we need to back the Senate version, because it's the version that has the broadest support. Unfortunately, I also understand the Senate version (and if I'm wrong on this, correct me) is little more than a strong encouragement for parity, whereas the House version is a mandate.

    The ironic thing about all of this: The House version effectively requires that the benefits be held in parity just like the healthcare plans for Fed employees provide. Net: anyone in Congress -- Senate or House -- who opposes the House version is essentially telling the American people they don't deserve a plan that's as robust as the one provided Fed employees and their families.

    On this topic, I am NOT a moderate.
  • domajot
    I;m surprised at Ted kennedy's position on mental health, as that is an issue chanpeioned by Eunice Shriver and many of the Kennedy clan. It was also an issue championed by the Carters (especially Mrs. C), btw.

    I think the US has been absolutely medieval in how it deals with mental health issues.
  • DLS
    I found the timing of this effort annoying, given that there's likely to be the same kind of opposition to this by the Bush administration and many Congressional Republicans as there was to the stunts the Dems tried with S-CHIP (for which they correctly were put in their place). It's annoying -- can't they exhibit at least minimal intelligence and wait until a Dem is in the White House, so they know they've got a chance at passage and even may be encouraged to try for more?

    Then I believe it was this morning I heard that the Republicans are trying to get some bill passed that appeals to some conservatives. I forget what the bill was about; the point is that obviously both sides in Congress are playing games to involve themselves with election-related issues and appeals to the voters.
  • DLS
    "a plan that's as robust as the one provided Fed employees and their families"

    Note that this is an alternative to extending Medicare to more beneficiaries as well as to other proposals such as the "mandatory insurance" that's really a concealed taxation scheme. (And it's never been insurance but pre-paid, often-comprehensive health care.) (Even if mental and dental benefits aren't great)
  • superdestroyer
    I love how people support government mandates for expanded medical coverage while complaining that their health insurance is too expensive. I guess people really do want to have it both ways.

    Of course, Senator Obama and Clinton believe that the way to make healthcare afford it to let others (read rich whites) pay for it. The real question is what are the Democrats going to do when there are not enough rich whites to tax in order to fund government handouts for everyone else.
  • DLS re: waiting - I don't know if you've followed this effort, but it's been going on since at least the mid-1990s. I don't really see mental health parity as an election-related issue - my point in connecting it to Obama and Clinton is that it's a health care issue and if they're talking health care coverage, I'd like to know where they are on it.

    But as I think about this - I forgot McCain, duh, in my post - where is he - I'll have to go back to see if he was a co-sponsor and whether he is one of the senators who wants to not meet.

    Also - think about Walter Reed and the mental health issues facing military familes and their non-military relatives who suffer when they suffer.
  • domajot - I agree re: the U.S. being medieval when it comes to its views/treatment of mental health issues across the board.
  • Pete - thank you SO much for this comment - I wasn't really aware of that distinction re: members of Congress already get this coverage. I hate it when that happens i.e., coverage for child care for them versus everyone else, they used to be exempt from civil rights laws (that was changed a few years ago though) and so on.

    Anyway - really glad you chimed in.
  • domajot
    Jillmz,,

    I want to thank you for the content of this post.
    We should be discussing the differences between Hillary and Obama on issues, instead of indulging in the day-in, day-out verbal slug fests on a good guy/bad guy theme..

    I don't know how mental health figues in, but Obama's overall health plan is much more modest overall. It has the advantage of rankling the opposition less and thus having better chances at being passed into law.
    On the other hand, Hillary made a sensible comment by pointing out how every proposal is likely to be nibbled to death.
    At his point, I tend to favor just putting forward the best plan possible, while realizing that some compromise will be necessary down the road. That would be true for mental health as well as health care in general.
  • DLS
    "I guess people really do want to have it both ways."

    It's a funny thing. First of all, it's obviously not insurance, but pre-paid health care. As to its comprehensivity, it really gets silly to require such generous health plans that the high costs make it prohibitively expensive. True insurance would be for catastrophic care, period. What we have seen in places like Massachusetts has been demands for "Cadillac" or "gold-plated" plans as minimum requirements. I remember Massachusetts years ago from experience (rejected going to live and work there due to this, as well as other problems, such as ridiculous taxation), and the situation has gotten no better there.

    http://news.bostonherald.com/news/opinion/edito...

    * * *

    "I don't really see mental health parity as an election-related issue"

    Originally I didn't; I just thought the Dems were being silly, not having learned from their S-CHIP nonsense, though I thought they should know they'd face problems and they were possibly just trying to make health care of all kinds an issue in this election. Then the Republicans were in the news doing something conservative, and I was convinced at least some motive must be to get issues out there before November.
  • DLS
    Jillmz,

    "I don't know if you've followed this effort, but it's been going on since at least the mid-1990s."

    Yes -- it makes the news from time to time.

    "Also - think about Walter Reed and the mental health issues facing military familes and their non-military relatives who suffer when they suffer."

    Actually this is special not because it's VA (which other than Walter Reed had for a while been considered to have been improving over the horror-story reputation it had held in the past -- and functioned as an example of warning about federal health care for all, "the VA model"). What's special this time is the scandal about how the mental problems are being treated by our current federal government in a way similar to the HMOs with recission of insurance policies -- the feds say that the soldiers were in fact mentally ill prior to their going to Iraq, just not exhibiting any problem behavior until exposed to combat or the occupation hazards, and as they were ill before going to Iraq, they don't qualify for benefits. You probably had learned about this in the news a while ago.

    Example:

    http://www.sfgate.com/cgi-bin/article.cgi?f=/c/...
  • Thanks for adding that, yes. For years, the mental health agency I worked at took kids with CHAMPUS coverage and then the benefits were dramatically curtailed - that was in the mid-90s when the HMO movement was taking hold in mental health.
  • DLS
    I am cynical and suspicious about the "wellness" organizations as well. Both with them and people in government gushing about saving fabulous sums with chronic illness management, I have to say I find them annoying as can be. There is no magic savings, and nobody needs to be nagged or socially engineered to death in the name of their better health. And with the wellness organizations, I have done some research and can reasonably draw sinister inferences (affecting hiring and layoff, i.e., firing, decisions by those businesses who are hiring these organizations) from what I have encountered here (see below). Bear in mind any new mental illness treatments might classify the sufferer as having a chronic condition.

    http://www.matria.com/resources/papers/wp_predm...
  • Again, as someone who has worked in the mental health field and knows many who still do, the money, time and energy lost because we don't treat mental health issues the way we treat physical health issues is staggering. I read several human resource magazines every month and they are replete with examples, quantitative and qualitative. This isn't about people who want to take a day off, are feeling blue or have pms, you know.
  • StockBoySF
    Jill, I didn't really find anything on Hillary's website but I got this from Obama's:

    "Improving Mental Health Care: Mental illness affects approximately one in five American families. Veterans returning from Iraq and Afghanistan are coming home with record levels of combat stress. The National Alliance on Mental Illness estimates that untreated mental illnesses cost the U.S. more than $100 billion per year. Barack Obama is a supporter of the bipartisan Paul Wellstone Mental Health and Addiction Equity Act of 2007, and, as a state senator, Obama helped pass a mental health parity bill that requires coverage for serious mental illnesses to be provided on the same terms and conditions as are applicable to other illnesses
    and diseases. As president, Obama will support mental health parity so that coverage for serious mental illnesses is provided on the same terms and conditions as other illnesses and diseases. For veterans, Obama will improve mental health care at every stage of military service—recruitment, deployment, and reentry into civilian life."

    Sorry I can't help with the list of which legislators did what. I hope the above on Obama is interesting, though it doesn't really answer your question.
  • Thanks, Stockboy. :) But - that's from Obama's site, yes? Not Hillary's I think??
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