Mental Health Coverage in Bush's Hands (4/29/02)
by Dean Hartwell
President Bush said he
supports legislation that will make health coverage for mental illness just as
comprehensive as coverage for other illnesses. He has a good idea: the National
Alliance for the Mentally Ill estimates that 5.4 percent of all adults in the
United States have a serious mental illness.
Right now, employers can offer less coverage for mental illnesses in health
plans. They can also limit reimbursements and payouts and increase premiums for
patients. Because of these differences in coverage, many mental health advocacy
groups have called for "parity" in coverage.
But, getting a bill that accomplishes this goal will not be easy. Legislation
mandating parity in coverage will likely increase the costs of health
insurance. Many Republicans in Congress, such as Speaker Dennis Hastert and
House GOP assistant leader Tom DeLay, have indicated they will not support a
bill that would cost employers more.
Others ask for exemptions for employers who face increase in costs of one
percent or more. But, the leading bill at this time, sponsored by Senators Paul
Wellstone and Pete Domenici, does not allow exemptions.
Even if the issue of cost increases could be resolved, there is still wide
disagreement as to what mental illnesses should be covered. Wellstone and
Domenici want to include all 200 illnesses in the Diagnostic and Statistical
Manual of Mental Disorders. Opponents want to limit inclusion to the most
serious mental illnesses, such as schizophrenia and bipolar disorder.
With the lack of consensus as to the details of a new law on mental health care
coverage, President Bush may eventually be the one who can get a version of a
bill passed by indicating his support. In short, he will have to decide to back
a bill that will include more people or one that will cost less.
In my book Truth Matters, I explain that politicians are better off
understanding the details of an issue and telling the public their point of
view with specifics instead of vague statements. We'll see if the President has
done his homework.