Mental health parity bill advances

The Wellstone-Ramstad effort, aka “the mental health parity bill” passed the House yesterday, 268-to-148 (See roll call vote), and, yes, that is Rep. Jim Ramstad standing next to Nancy Pelosi in today’s New York Times article. Forty-seven Republicans joined 221 Democrats in voting for the bill, which requires insurance companies to consider a mental illness in the same manner they consider a physical illness.

President Bush endorsed the notion in 2002, but on Wednesday he opposed it.

But far from creating an entire new class of coverage, the bill actually closes a loophole. Under a 1996 law, health plans are forbidden to set annual or lifetime dollar limits on mental health care that are lower than the limits for other services. But insurance companies got around the law by setting different limits on visits and co-payments.

Pharmaceutical companies aren’t all that thrilled with the bill because of the way it will be paid for. The Medicaid rebate, in which the companies discount revenues from sales to Medicaid patients, will be increased by about 5 percent. Eli Lilly, for example, says that’ll increase costs for other patients.

Minnesota’s state law requires parity already. Does it make a difference in costs to business or consumers? Medica officials are quoted in an Ohio research report as estimating the cost at 26 cents a month for subscribers — $3 a year.

The debate isn’t over. The House bill has to be reconciled with the Senate version, which has the insurance companies’ blessing, and covers a narrower range of illnesses.

Might this be an issue in the presidential campaign? Maybe. None of them had anything to say about the issue on Wednesday. But the National Alliance on Mental Illness has candidate questionnaires available for Clinton and Obama. John McCain submitted a statement instead, which offered little in the way of a clear position on the issue.