Celebrations of last year's landmark mental health parity legislation ending insurance and business discrimination were premature. What once seemed a turning point now seems less certain if the federal guidelines for implementation of the Wellstone-Domenici Mental Health Parity and Addiction Equity Act are delayed beyond the Oct. 3 deadline. Such a delay could spell disaster for the 46 percent of the population whose treatment will be halted or never started, with lives lost, livelihoods delayed, but the status quo intact.
We should recall that parity was hotly debated before two bills (HR 1424 in the House, S 558 in the Senate) and were folded into last year's stimulus package. It was an initiative supported by a unique collaboration between advocates in the mental health community and those in the addiction community, with coverage extending to the self-insured and to those in Medicaid managed care. The House initiative, led by Reps. Patrick Kennedy and Jim Ramstad, wanted to base treatment criteria on the American Psychiatric Association's Diagnostic and Statistical Manual. Insurance and business were able to determine that the Senate's bill allow them to define "medical need."
This provision, allowing the insurance companies to manage medical conditions, mandated there be no discrimination against mental illnesses or addictive disorders. Yet, many companies are attempting to reduce what they are calling "medical necessity" and in this way are encouraging the Departments of Health and Human Services, Labor and Treasury to undermine the fact and the spirit of parity………
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