The-F-Word.org

After two weeks of contentious and high-spirited debate, the federal government’s ambitious and historic plan to bail out the nation’s financial system was signed into law by President Bush on Friday. While H.R. 1424 is intended to resuscitate the nation’s ailing financial health, the act also helps to improve the nation’s mental health: Amongst the “sweeteners” included in the bill is the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.

The critical mental health legislation, 10 years in the making, provides equity in the coverage of mental health and substance use disorders by ensuring that group health care plans do not charge higher co-payments, coinsurance, deductibles, and impose maximum out-of-pocket limits and lower day and visit limits. The law doesn’t require health insurers to cover mental health care, but if they do, they’ll have to treat psychological and addictive disorders the same they do other medical conditions. In other words, insurers will no longer be able to limit the number of visits or charge higher deductibles or co-payments for mental health and substance abuse services.

According to NAMI, the parity law becomes effective one year after enactment of the bill. There’s also a special effective date rule for collective bargaining agreements that would delay imposition of the bill’s requirements until the next collective bargaining contract goes into effect. The Departments of Labor, Health and Human Services and the Treasury are required to issue regulations within one year, but failure to issue regulations will not delay the one-year bill effective date.

Can I even begin to explain how incredibly monumental this is? At least 17 states have mental health parity laws, but these do not apply to employers that fund their own insurance plans, including many large companies. This legislation extends these protections to Americans in health plans of 51 or more employees, including — for the first time — those in self-insured employer health plans. Mental illnesses constitute the second leading cause of disability and premature death in the United States. Eating disorders alone cost U.S. companies about $3.8 billion a year in lost productivity. Mental illness is as deadly as cancer and this act finally forces group health insurance plans to treat it as such.

Sens. Paul Wellstone (D-Minn.) and Pete Domenici (R-N.M.) first teamed up in 1996 to win passage of a law banning insurance plans that offer mental health coverage from setting lower annual and lifetime spending limits for mental treatments. They paired up again in 2001 on a predecessor to the legislation that just passed. After Wellstone was killed in a plane crash in 2002, a bipartisan group of senators and representatives took the initiative to see the bill named in his memory through to passage. The bill was finally set to pass last month when economic disaster struck, with many fearing that the bill would languish and die in Congress while members redirected their energies to the economic bail-out. But in an act of Congressional housekeeping, the bill was rolled in with the now-passed and freshly-signed economic bail-out bill.

A big round of applause for those Congressmen who introduced the original measures: Senators Pete V. Domenici (R-NM), Edward M. Kennedy (D-MA), and Michael B. Enzi (R-WY) and Representatives Patrick Kennedy (D-RI) and Rep. Jim Ramstad (R-MN). And to Paul Wellstone, wherever you are, thanks. Most of us will never change the world, but some, like Wellstone, do. It’s now up to us to change ourselves.