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Washington, D.C. – Today, Rep. Doris Matsui (CA-05) announced that the U.S. House of Representatives passed the Paul Wellstone Mental Health and Addiction Equity Act of 2007.  The bill will provide equity in the coverage of mental health and substance-related disorders compared to medical and surgical disorders. 

 

The Mental Health Parity Act will ensure that mental health disorders are treated with the same care and attention as traditional physical disorders.  Under the legislation, insurance providers would have to offer mental health coverage that is comparable to the coverage offered for medical services. 

 Last year, Rep. Matsui held a field hearing in Sacramento on mental health.  It provided the constituents of the Fifth Congressional District with a forum for important dialogue about an issue that affects millions of Americans. 

“Living with a mental illness is just as painful and challenging as living with a physical illness.  In many ways, mental health patients suffer more because our insurance system discriminates against them,” said Rep. Matsui.  “That is why this legislation is so important … because it is about people who struggle with mental illness every day.”

 

“Today, we demonstrated our compassion and commitment to people who suffer in silence without a doctor’s help … because their insurance will not cover mental health or addiction treatments.  With one vote, we put behind us the false conception that mental health is not as serious as other diseases covered by health insurance,” said Rep. Matsui.

 

The Paul Wellstone Mental Health and Addiction Equity Act ensures that group health plans do not charge higher co-payments, coinsurance, deductibles, impose maximum out-of-pocket limits, or impose lower visit limits on mental health and addiction care than for medical surgical benefits.  It also allows the Department of Health and Human Services, the Department of Labor, and the Internal Revenue Service to penalize health plans for discriminatory practices.

 

The bill, while not mandating plans to provide mental health coverage, will require that if mental health coverage is include, there must be:

 

• Equity in financial requirements.  A plan cannot apply more restrictive or costly financial requirements to mental health and substance-related disorders than to comparable medical and surgical benefits.
• Equity in treatment limits.  Any treatment limitations applied to mental health and substance-related disorders cannot be more restrictive to physical health coverage.  Treatment limitations include caps on the frequency or number of visits, limits on days of coverage, or other similar limits on the scope and duration of treatment.
• No discrimination based on diagnosis.  The plan must cover the mental illnesses included in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the mental health practitioner’s guide to mental illnesses.  This is the same coverage that Members of Congress have.
• Equality in out-of-network coverage.  If the plan offers out-of-network benefits for medical and surgical benefits, then it must also offer these benefits form mental health disorders.

 

“This legislation is both timely and necessary.  It will help civilian citizens and our veterans alike.  Sadly, we have heard that an unprecedented number of our men and women returning from Iraq and Afghanistan will suffer from Post Traumatic Stress Disorder.  Ridding our system of the stigma associated with mental health treatments will pave the way for our veterans to have adequate access to the care they need to be happy and productive upon their return home,” said Rep. Matsui.

 

The bipartisan Paul Wellstone Mental Health and Addiction Equity Act enjoys strong bipartisan support.  It has been endorsed by: the American Medical Association, American Hospital Association, American Nurses Association, American Academy of Pediatrics, National Hispanic Medical Association, American Counseling Association, National Association of Social Workers, Families USA, American Psychiatric Association, American Psychological Association, national Mental Health Awareness Campaign, and Mental Health America.

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