Parity: states lead the way, despite implementation challenges: achieving equal coverage marked by obstacles.

Publication: Behavioral Healthcare Tomorrow

Publication Date: 01-AUG-05

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COPYRIGHT 2005 Manisses Communications Group, Inc.

As a priority policy issue, mental health parity probably reached its apex on April 29, 2002. President George W. Bush, in conjunction with his announcement establishing the President's New Freedom Commission on Mental Health, endorsed the concept of mental health parity and pledged to work with Congress on its passage.

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"Health plans should not be allowed to apply unfair treatment limitations or financial requirements on mental health benefits," declared Bush.

After years of lobbying by field leaders and a compromise victory in 1996 for limited federal mental health parity, the stars finally seemed aligned for the enactment of comprehensive federal mental health parity. But it was not meant to be. Two House committees held historic, well-publicized hearings in 2002, but legislation still did not move.

Later that year, Congress's champion of comprehensive parity, Sen. Paul Wellstone (D.-Minn.), died tragically in an airplane crash.

The following year, more determined than ever, Sens. Pete V. Domenici (R.-N.M.) and Edward M. Kennedy (D.-Mass.) introduced the Senator Paul Wellstone Mental Health Equitable Treatment Act, with a companion bill introduced in the House by Reps. Patrick J. Kennedy (D.-R.I.) and Jim Ramstad (R.-Minn.). And later in 2003, the president's mental health commission, as part of its report, endorsed comprehensive mental health parity.

Despite more than 350 co-sponsors in Congress and broad public support for the concept that insurance terms should be equal for mental and physical illness, comprehensive mental health parity still has not been enacted federally. Certainly the Sept. 11 terror attacks and the subsequent invasions of Afghanistan and Iraq helped to push mental health parity and a host of other domestic issues to the back burner. And in 2004, passage of the Medicare Modernization Act (MMA) took center stage in health policy.

Federal inertia on parity, however, has not prevented states from acting on behalf of mental health consumers. Thirty-eight states now have some level of mental health parity in place. The National Mental Health Association (NMHA) identifies...

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