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S. 558, The Mental Health Parity Act of 2007
- This item is from the 110th Congress (2007-2008) and is no longer current. Comments, voting, and wiki editing have been disabled, and the cost/savings estimate has been frozen.
Comparing original version (created by webmaster) with revision saved on September 20, 2007, 18:40:46 (webmaster):
S. 558 would provide parity between health insurance coverage of mental health benefits and benefits for medical and surgical services.
== Detailed Summary ==
<summary>
Mental Health Parity Act of 2007 - (Sec. 2) Amends the Employee Retirement Income Security Act (ERISA) and the Public Health Service Act to require a group health plan that provides both medical and surgical benefits and mental health benefits to ensure that: (1) the financial requirements applicable to such mental health benefits are no more restrictive than those of substantially all medical and surgical benefits covered by the plan, including deductibles and copayments; and (2) the treatment limitations applicable to such mental health benefits are no more restrictive than those applied to substantially all medical and surgical benefits covered by the plan, including limits on the frequency of treatments or similar limits on the scope or duration of treatment. Prohibits the plan from establishing separate cost sharing requirements that are applicable only with respect to mental health benefits.
Requires that such a plan ensure that the requirements of this Act are applied to both in- and out-of-network services, if offered, by comparing in-network medical and surgical benefits to in-network mental health benefits and out-of network medical and surgical benefits to out-of-network mental health benefits.
Excludes from the requirements of this Act any group health plan: (1) for an employer with not more than 50 employees; or (2) whose costs of compliance with this Act increase the total costs of coverage by more than a specified percentage. Requires that determinations as to increases in actual costs under a plan be made by a qualified actuary and be made available to the public.
(Sec. 4) Supersedes any provision of state law that establishes, implements, or continues in effect any standard or requirement that differs from the requirements of this Act, except for laws relating to the individual insurance market or small employers.
(Sec. 5) Requires the Secretary of Labor and the Secretary of Health and Human Services to designate an individual within their departments as the group health plan ombudsman to serve as an initial point of contact to permit individuals to obtain information and provide assistance concerning coverage of mental health services under group health plans in accordance with this Act. Requires the Secretaries to provide for the conduct of random audits of group health plans to ensure compliance with this Act.
Requires the Comptroller General to study the effect of this Act on the cost of health insurance coverage, access to such coverage, the quality of health care, and the impact on benefits and coverage for mental health and substance abuse.
</summary>
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== Status of the Legislation ==
<status>
Latest Major Action: 4/11/2007: By Senator Kennedy from9/19/2007: Referred to House committee. Status: Referred to the Committee on Health, Education, Labor,Energy and Pensions filed written report. Report No. 110-53.Commerce, and in addition to the Committee on Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
</status>
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== Points in Favor ==
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== Points Against ==
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Visitor Comments
Joe
May 9, 2007, 10:31am (report abuse)I don't get this. Psychiatrists say they can't actually determine for sure if someone is mentally ill, and they say they can't actually cure any mental illnesses, so how is this anything but a method to suck huge amounts of money out of American's pockets? There is no way to actually prove that anything useful is actually being done with this money.
Laurie
June 8, 2007, 3:00pm (report abuse)Will this bill override any individual state's similar bills, as in "Timothy's Law" in New York, which directly specifies how many inpatient and outpatient visits will be allowed, and if chemical dependency will be included?
Julie
June 12, 2007, 4:43pm (report abuse)Joe, psychiatrists do have a bio test to determine for sure. It's called a SPECT scan. It's extremely expensive and only done two places in the country. What the SPECT scans do show is that the current symptom inventory diagnoses that psychiatrists are using are accurate. If you want someone who thinks God's talking to them to knife you in your bed one night, feel free not to pay.
Julie
June 12, 2007, 4:52pm (report abuse)There is plenty of proof that psychiatric treatment works for serious mental illnesses--enough proof to satisfy anyone who isn't crazy, that is.
There are a lot of incurable illnesses out there. If you don't treat depression, you end up with a jumper splattering your wife or daughter with blood and brains when they hit the sidewalk.
Untreated mental illness is more unpleasant and hazardous to your friends and family that some stranger's untreated diabetes and emphysema.
Mental health parity helps the patient, sure. It also protects society from the patient.
Or did you like what happened at Virginia Tech?
Jill
June 16, 2007, 8:50am (report abuse)Children diagnosed with autism are being denied medical coverage because of their pre-existing condition. That means one out of 150 children do not get health coverage since one of out 150 children are diagnosed with autism. I hope this bill passes so that my children will be able to have health coverage and I will not have to pay out of pocket for their EEG's, ABA treatment, speech, occupational therapy and their regular health checkups.
M
July 4, 2007, 1:43pm (report abuse)Joe, the point is that currently, while it is no problem to get treatment for physical illnesses like diabetes, cancer, high blood pressure, etc., people cannot get similar medical treatment for mental illnesses, and this is discriminatory. It is based off of the stigma and discrimination against people with mental illnesses. Plus, it is a serious problem considering that many physical illnesses are direct results of mental illnesses. For example, when a person is depressed or severely anxious their body is under a tremendous amount of stress. These people often develop subsequent physical problems, like high blood pressure and diabetes. In fact, one of my collegues attended a conference with MH policy makers and MH consumers, and the refrigerators at the conference would not fit all of the diabetes medication that people brought. This should tell us something. Why are we separating mental and physical illnesses when they are very much so interconnected?
M
July 4, 2007, 1:45pm (report abuse)Julie, while you are right in saying that the Senate should indeed pass this bill, let's not focus the reason for doing so on the fact that a very small minority of people who are mentally ill might do something violent or harmful to others. Rather, let's change the conversation to the fact that over 25% of the U.S. population suffers from mental illnesses, and most of them are completely "normal" people just like you. My mother has suffered from depression, and so have a few of my close friends. We should pass the bill because it is what is just and right.
M
July 4, 2007, 1:46pm (report abuse)Joe, since you're worried about prices going up, you should check out the Congressional Budget Office projections for the bill. It predicts that it will only raise the cost on average about 0.4% initially. Then, over the long haul (which is what we should always focus on), parity for mental health treatment would actually lower healthcare costs! Why? Well, let's think about how much productivity is lost on the job when people who are depressed stay home from work, but can't afford treatment. It is reported that the U.S. loses over $75 million per year over this.
But, more important than the monetary costs, let's consider the cost of mental illnesses on the health of those individuals who suffer with them AND on the family members who take care of them. It's truly overwhelming. Let's step up and do the right thing. Let's get this parity bill passed!
M
July 4, 2007, 1:49pm (report abuse)Timothy's Law, as Laurie refers to above, was passed because Timothy, a very young boy killed himself after he had suffered for years with depression, and his parents were unable to obtain adequate mental health treatment for him because their insurance would not pay for it, and they couldn't afford the enormous out of pocket expenses. Timothy was not "crazy." He was very sick. Let's not allow this to happen any more.
Anthony
July 16, 2007, 11:03am (report abuse)Laurie
Yes, this bill will override any individual state's similar bills, even if the state's current laws are more restrictive.
In addition to providing no protection for existing, stronger drug and alcohol addiction and mental health treatment laws, S.558 surrenders and FEDERALIZES control of all treatment decisions to managed care.
The wording in these laws can be tricky to interpret and even worse, intentionally misleading. Most in congress never even read them as long as they "sound" good on the surface.
Marjorie
November 25, 2007, 5:49pm (report abuse)Autism is NOT a mental illness; however professionals who provide therapies (prescribe medications that treat symptons, provide social skills groups, provide behavior therapies) are psychiatrists and psychologist and social workers. These professions are covered under "Mental Health" insurance coverage, not medical coverage (even though a psychiatrist is an MD - which means medical doctor!) The cost of a visit to a psychiatrist in NY is $275 or more per visit. Our insurance covers 50% of usual and customary -- which they have decided is only $200 so I get $100 back per visit. I pay $175 out of pocket. On the other hand, if we saw a neurologist our out of pocket with our plan would be only 20%. Why is one profession better covered than another?