Psychology’s goal of achieving full mental health insurance parity took a major step forward in late October when the Senate passed by voice vote S.543, the Mental Health Equitable Treatment Act, as an amendment to the appropriations bill for the Departments of Labor, Health and Human Services (HHS) and Education.

Psychology leaders were particularly impressed by Senate passage of a parity amendment when most activity in Congress was focused on the aftermath of the September 11 terrorist attacks. “The fact that the Senate found a legislative mechanism not related to terrorism to pass mental health parity shows that this issue is very significant,” said Practice Directorate Executive Director Russ Newman, Ph.D., J.D. Though Rep. Marge Roukema (R-NJ) had introduced a mental health and substance abuse parity bill, the House of Representatives had not yet acted on parity legislation this year when the Senate passed S. 543.

If enacted, the parity amendment would prohibit most group health plans from imposing treatment limitations or financial requirements involving deductibles, copayments, and out-of-pocket contributions on mental health benefits unless comparable limitations are applied to medical and surgical benefits. The Senate bill, which would take effect in January 2003, provides for in-network parity and would apply to companies with more than 50 employees that offer mental health coverage, that is, it would not require businesses to begin offering such coverage.

The parity amendment was offered by Senators Pete Domenici (R-NM) and Paul Wellstone (D-MN) and 64 additional Senate co-sponsors. It expands on the Mental Health Parity Act of 1996, which expired September 30, by closing loopholes that some employers have used over the past five years—such as placing limits on inpatient days and outpatient sessions, maximum out-of-pocket limits, and raising copayments and deductibles.

Because the House of Representatives did not take up parity, its Labor-HHS-Education appropriations bill passed without a mental health insurance parity provision. At press time for this newsletter, the appropriations bill had gone to a Senate-House conference committee to resolve differences in the two bills. APA staff coordinated 136 national organizations signing a Mental Health Liaison Group letter that asked the conferees to retain the Domenici-Wellstone parity amendment. Marilyn Richmond, J.D., the Practice Directorate’s assistant executive director for government relations, observed that the APA Practice Organization anticipates a tough battle in conference as parity opponents in the employer community mobilized to have the Senate parity amendment seriously weakened or dropped from the final appropriations bill.