House Energy and Commerce Health Subcommittee Resumes Discussions on Mental Health Parity, Patients’ Rights

The House Energy and Commerce Health Subcommittee on July 23 heard testimony on a bill (HR 4066) that would require employers to provide the same level of coverage for mental health as for physical health care, CongressDaily reports (Fulton, CongressDaily, 7/23). The Mental Health Equitable Treatment Act of 2002, sponsored by Rep. Marge Roukema (R-N.J.), is identical to the parity bill (S 543) passed last year by the Senate but defeated in a House-Senate conference committee. Both bills would build on the 1996 mental health parity law, which prohibited health plans that cover mental illnesses from setting different annual and lifetime benefits for those illnesses than they do for physical illnesses but does not prevent insurers from establishing higher deductibles or copayments for mental health benefits than for other medical conditions, a loophole that the new proposals seek to eliminate (Kaiser Daily Health Policy Report, 6/18). Health subcommittee ranking member Sherrod Brown (D-Ohio) said that the legislation is a "thoughtful compromise bill." He cited a Congressional Budget Office report that estimated that the legislation would increase health insurance premiums by 0.9% on average. However, officials with the National Association of Manufacturers, which opposes the bill, said the CBO "qualified" its estimate earlier this month, saying that because its calculation represents a "weighted average of the effects across both affected and unaffected plans," some companies could "experience increases in premium costs higher than 0.9%." Health subcommittee Chair Michael Bilirakis (R-Fla.) added that there are certain mental conditions that "just like some physical conditions, do not warrant 'equal' treatment by a health plan."

Patients' Rights
Rep. Greg Ganske (R-Iowa) used the hearing as an opportunity to call for a House-Senate conference committee on "long-delayed" patients' rights legislation, CongressDaily reports (CongressDaily, 7/23). The Senate last year passed a bill that would allow patients to sue HMOs in state courts -- which often award larger damages than federal courts -- for denial of benefits or quality of care issues and in federal court for non-quality of care issues. The legislation would cap damages awarded in federal courts at $5 million but would allow state courts to award as much in damages as states allow. A bill passed last year by the House would allow patients to sue health plans in state courts only for non-economic damages up to $1.5 million. It would also allow courts to award patients up to $1.5 million in punitive damages, but only in cases where patients won complaints against health plans before an outside appeals panel and an HMO still refused to provide care (Kaiser Daily Health Policy Report, 6/7). Senate Majority Leader Tom Daschle (D-S.D.) has declined to appoint conferees this year, saying he prefers to give President Bush and congressional leaders a chance to "negotiate informally" (CongressDaily, 7/23).

A HealthCast of the hearing is available online.