Bailout Bill Packaged with Mental Health Parity Passes

By Bill Leonard Oct 3, 2008
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The financial system bailout bill approved by Congress and sent to President Bush for his signature includes a provision that will require group health plans to place mental health benefits on equal footing with other health care benefits.

With final House of Representatives approval on Oct. 3, 2008, the legislation, which provides $700 billion to keep credit flowing through the troubled U.S. economy, ended a week of turmoil on Capitol Hill. But, because of a quirk in congressional procedure, it was actually the mental health parity bill that Congress approved—with the bailout along for the ride.

On Wednesday, Oct. 1, the Senate turned a mental health parity proposal that was first introduced in the House of Representatives into the massive financial system bailout bill (HR 1424). Two days later, the House reversed its earlier opposition to the bailout and voted handily for its approval.

While most of the nation’s attention was focused on efforts to allow financial institutions to try to dig out of the credit crisis without the taxpayers bearing too much of the risk, a number of sweeteners were added to the package during the week, such as previously stalled proposals to grant tax breaks to small businesses.

But technically it was the mental health proposal that carried the entire package to the finish line.

The law will apply only to group health plans that provide mental health benefits. The Mental Health Parity Act of 1996 requires group health plans to provide some comparable benefits for mental health treatments. However, most provisions of the statute were set to expire at the end of 2008.

The House and Senate passed similar versions of the mental health measure in September 2008. However, because the House passed a stand-alone bill (HR 6893) and the Senate packaged the proposal in a bill to extend energy and business-related tax incentives, the proposal never gained formal approval from both chambers in the same form—until packaged with the massive financial system bailout measure.

The situation confused several news organizations and business groups, which reported prematurely that the mental health parity legislation had passed Congress.

The mental health provisions in the package approved Oct. 3 will prohibit employer group health plans from imposing limitations on coverage for mental illnesses that they do not impose on physical illnesses. For example, the legislation would require that group health plans offer the same terms for deductibles, limits on hospital stays and outpatient visits, and insurance co-payments.

The provisions included in the final bill closely resemble a mental health parity proposal (S 558) approved by the Senate in September 2007. Several business and employer groups, including the Society for Human Resource Management, had announced their support for the Senate version. House and Senate negotiators had announced a tentative agreement to approve the measure in July 2008, but the compromise fell apart after negotiators disagreed on how to pay for the proposal’s estimated $3 billion cost in lost tax revenues.

Opponents of the mental health parity proposal have argued that it would cost too much and that many employers would choose to eliminate health insurance plans rather than pay for the additional benefits. The final legislation was designed to strike a balance between the needs of patients and the cost constraints faced by employers, according to supporters of the measure.

Bill Leonard is senior writer for HR News.

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