The concerns of state insurance regulators that federal standards on mental health parity legislation serve as a floor and not as a ceiling to state action constitute a major barrier to enactment of such legislation, according to testimony at a House hearing last week.
The fault lines, between business interests as represented in the Senate bill, and consumer interests, as represented in the proposed House bill, were exposed at the hearing on July 10 before the Education and Labor Health, Employment, Labor, and Pensions Subcommittee of the House Education and Labor Committee.
The differences sets up difficult negotiations on final legislation, talks that are unlikely to occur before next year, according to Rep. Patrick Kennedy, D-R.I., a sponsor, along with Rep. Jim Ramstad, R-Minn., of the House bill.
A critical concern is that the Senate bill–supported by business interests–allows states to continue regulating insurance plans as they do now, but it would not permit new state laws.
By contrast, the House bill gives states some leeway to impose new laws on insurers and employers, such as requiring certain coverages or limiting insurers’ oversight abilities.
The Senate bill, S. 558, was reported out by the Senate Health, Education, Labor and Pension Committee earlier this year. It is sponsored by Sen. Ted Kennedy, D-Mass., chairman of the committee, and Sen. PeteDomenici, R-N.M.
House Committee officials hope the Kennedy-Ramsted House bill, H.R. 1424, the Paul Wellstone Mental Health and Addiction Equity Act, is acted upon, at least by the committee, before the August recess, according to officials at the American Benefits Council, which strongly supports the Senate bill.
The concerns of insurance regulators with the Senate bill were voiced at the hearing by Sean Dilweg, Wisconsin insurance commissioner.
“It would be very problematic for Wisconsin and other states if the House were to move in the direction of the Senate with regard to preemption,” Dilweg said.
He said the Senate version preempts, subject to certain exceptions, any state mental health parity standard or requirement which differs from the mental health parity standards or requirements as defined in a provision of the Senate bill.