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A mental-health insurance parity bill might finally pass Congress

WASHINGTON—He was a pioneer by circumstance, not by choice.

But 35 years after former Democratic Sen. Thomas Eagleton of Missouri was forced to abandon his bid for vice president after he disclosed that he'd been treated for depression, politicians no longer keep their and their families' battles with mental health in the dark.

In a speech on the Senate floor in January, Republican Gordon Smith of Oregon said there was an epidemic of youth suicide that "begins as depression and sometimes leads to tragic results." His 21-year-old son killed himself in 2003.

The stories are familiar. Senate Majority Leader Harry Reid, D-Nev., said his father committed suicide and that it took him a long time to acknowledge it in public. Sen. Debbie Stabenow, D-Mich., said her father was diagnosed as manic-depressive and that her family didn't even know what it meant at first.

Buoyed by such personal testimonies, a bipartisan coalition in Congress is pushing to pass a mental health-parity bill, which would require group health plans to offer similar coverage for mental and physical illnesses. It no longer would allow insurers to have different co-payments, deductibles and out-of-pocket limits for mental health benefits and medical/surgical benefits.

One of its chief sponsors in the House of Representatives is Rep. Patrick Kennedy, D-R.I., who checked into a clinic in Rochester, Minn., for drug treatment after he fell asleep and crashed his car near the Capitol last year. He's struggled with depression and drug addiction since he was a teenager.

Passage of the bill would be a major victory for mental health advocates, who've been lobbying hard for years. They say the 1972 disclosure by Eagleton, who died of heart and respiratory ailments last Sunday at age 77, was the opening salvo in the long national debate.

"He was a trailblazer," said Susan Crain Lewis, the president of the Mental Health Association of the Heartland, based in Kansas City, Mo. "It was unfortunate that he was forced into a position of having a stigma prevent him from doing all he was capable of for the people of our country."

Lewis said she tried to educate the public, and that most people were surprised to learn that Abraham Lincoln battled depression: "He's one of the biggies, and he struggled, and he was successful in spite—and maybe sometimes because—of it."

The ranks of the mentally ill have included: actor Drew Carey, columnist Art Buchwald, television journalist Mike Wallace, playwright Tennessee Williams and writers Ernest Hemingway and Charles Dickens, all of whom suffered from depression; and Theodore Roosevelt, Winston Churchill, businessman Ted Turner, actresses Patty Duke and Tracy Ullman, and Kitty Dukakis, the wife of former Massachusetts Gov. Michael Dukakis, all of whom had bipolar disorder.

Eagleton was on the Democratic ticket, led by former South Dakota Sen. George McGovern, for two weeks in the summer of 1972. He left the ticket after reporters Robert S. Boyd and Clark Hoyt of Knight Newspapers learned of his illness and Eagleton was forced to disclose that he'd undergone psychiatric treatment and electroshock therapy and had been hospitalized for depression three times.

While the parity legislation has broad support from rank-and-file members of Congress, Republican leaders have blocked final votes in previous sessions. Democratic leaders are promising to get it on President Bush's desk in the current session of Congress.

Many business groups oppose a new mandate on insurance coverage, saying it would result in higher costs that would force some employers to scale back other coverage. Proponents say the added costs would be minuscule. The legislation would affect any group health plans that cover 50 people or more.

Backers of the Senate version of the bill say that at least 113 million Americans would benefit from it. Sen. Edward Kennedy, D-Mass., one of three chief Senate sponsors, said that 20 percent of Americans would have some form of mental illness this year but that only a third of them would receive treatment. The other chief sponsors are Republicans Pete Domenici of New Mexico and Michael Enzi of Wyoming. The bill passed a Senate committee last month.

In the House, Patrick Kennedy teamed up with Rep. Jim Ramstad, R-Minn., on Wednesday to introduce their legislation, which already has 256 co-sponsors, including House leaders. They're proposing a broader bill that would provide more access to treatment for alcoholism and drug abuse.

"July 31st, 1981, I woke up in a jail cell in Sioux Falls, South Dakota, as a result of my last alcoholic blackout," Ramstad said. "I was under arrest for disorderly conduct and a host of other offenses. And I'm alive and sober today only because of the grace of God and the access to treatment I had."

Patrick Kennedy and Ramstad propose naming the legislation after the late Democratic Sen. Paul Wellstone of Minnesota, who championed the cause until he died in a plane crash in 2002. At a congressional hearing in Minneapolis in January, Sen. Amy Klobuchar, D-Minn., recalled how Wellstone's brother Steve had a severe mental breakdown and spent two years in hospitals, leading Wellstone to write: "For two years, the house always seemed dark to me, even when the lights were on. It was such a sad house."

At the Minneapolis hearing, John Hottinger, the former Democratic Senate majority leader in the Minnesota Legislature, said he told a friend he planned to commit suicide in 2003. He spent four days in a psychiatric ward, but said he overcame his depression with counseling and medication.

He recalled the early days of his struggle, when he tried to manage his illness with no help. "After all, I was a mature male, an attorney with political interests," he said. "And I was old enough to remember Thomas Eagleton."



WHAT? The Paul Wellstone Mental Health and Addiction Equity Act (HR 1367). The bill would require group health plans that offer benefits for mental health and addiction to do so on the same terms as other diseases.

Insurers couldn't charge higher co-payments, coinsurance, deductibles and maximum out-of-pocket limits and impose lower day and visit limits on mental-health and addiction care.

The legislation is modeled after the Federal Employees Health Benefit Program, which covers members of Congress and other federal workers and dependents.

It's named after the late Democratic senator from Minnesota who promoted the legislation until his death in 2002.

WHO? The chief sponsors of the bill are Democratic Rep. Patrick Kennedy of Rhode Island and Republican Rep. Jim Ramstad of Minnesota. They've lined up 256 co-sponsors and have been touring the country to tout the legislation.

WHY? Supporters of the bill say too many people aren't getting treatment because of inadequate insurance coverage.

WHEN? The House bill was introduced Wednesday, and similar legislation is pending in the Senate. Backers are hopeful they can get it passed in the current session of Congress.


(c) 2007, McClatchy-Tribune Information Services.

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