Members of the House Energy and Commerce Committee Health Subcommittee today approved H.R. 1424, the House version of a major mental health parity bill, by a voice vote.
Rep. Heather Wilson, R-N.M., offered an amendment that would have replaced the text of H.R. 1424, the Paul Wellstone Mental Health and Addiction Equity Act, with the text of the Senate version, S. 558.
Most insurance and employer groups and many mental health advocacy groups prefer S. 558, but Health Subcommittee members voted 19-9 to reject the Wilson amendment.
House Energy and Commerce Committee leaders expect the full committee to mark H.R. 1424 up next week.
Rep. Patrick Kennedy, D-R.I., who teamed with Rep. Jim Ramstad, R-Minn., to introduce H.R. 1424, continues to press hard for its passage. He is not a member of the Health Subcommittee, but he showed up today at the markup and talked quietly to the Republican subcommittee members as well as the Democrats on the subcommittee.
Both H.R. 1424 and S. 558 would require group health plans that offer mental health benefits to provide equal treatment for physical and mental health conditions, but the authors of S. 558 have included additional cost-control mechanisms, such as a provision that would permit health plans to utilize control procedures to manage mental health care.
Employer groups and other critics say H.R. 1424 includes an extra section that could increase costs, such as a provision requiring affected group plans to cover all conditions listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, a reference work published by the American Psychiatric Association, Arlington, Va.
Supporters of H.R. 1424 said today using the entire DSM is important to giving providers the flexibility they need to do their work. “It’s critical that we let the physician, not the insurance companies, make the decision,” said Rep. Gene Green, D-Texas.
Rep. Joe Barton, R-Texas, the most senior Republican member on the full committee, said the DSM includes diagnoses such as “jet lag” and caffeine-related disorders, and he argued that H.R. 1424 would require health insurers to provide equal treatment for heart attacks and for jet lag.
“I’ve had jet lag and I’ve had a heart attack,” Barton said. “It’s not the same.”
Rep. Nathan Deal, R-Ga., the most senior Republican on the Health Subcommittee, talked about an estimate from the Congressional Budget Office that H.R. 1424 could increase the average employer’s health insurance premiums by 4%.
Wilson, the lawmaker who tried to replace the text of H.R. 1424 with the text of S. 558, complained that the cost of implementing H.R. 1424 could force some employers to drop their health coverage, and she said members of the Senate are unlikely to pass H.R. 1424.
Although a number of Republicans spoke against H.R. 1424, a Pennsylvania Republican who is a psychologist, Rep. Tim Murphy, R-Pa., argued in favor of H.R. 1424.
“The diagnosis and treatment of mental illness saves money” for patients and businesses alike, Murphy said.
Requiring a group health plan to provide coverage for disorders listed in the DSM would require the plan to help pay for the cost of distinguishing between a minor order, such as jet lag, and a major disorder, such as a brain tumor, but it would not require the plan to pay for expensive treatments for the minor disorders, Murphy said.