[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 193 Introduced in House (IH)]







104th CONGRESS
  1st Session
                                H. R. 193

 To establish a comprehensive policy with respect to the provision of 
  health care coverage and services to individuals with severe mental 
                   illnesses, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 4, 1995

  Mrs. Roukema (for herself and Ms. Kaptur) introduced the following 
         bill; which was referred to the Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
 To establish a comprehensive policy with respect to the provision of 
  health care coverage and services to individuals with severe mental 
                   illnesses, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Equitable Health Care for Severe 
Mental Illnesses Act of 1995''.

SEC. 2. FINDINGS.

    Congress finds that--
            (1) American families should have health insurance 
        protection for the costs of treating severe mental illnesses 
        that is commensurate with the protection provided for other 
        illnesses;
            (2) currently, many private health insurance policies and 
        public insurance programs discriminate against persons with 
        severe mental illnesses by providing more restrictive coverage 
        for treatments of those illnesses compared to coverage provided 
        for treatments of other medical problems;
            (3) many health insurance plans limit the number of days 
        allowed for facility care or limit the number of outpatient 
        visits allowed for the treatment of severe mental illnesses 
        while providing no limit for the treatment of other physical 
        illnesses;
            (4) only 21 percent of all health insurance policies 
        provide inpatient coverage for severe mental illnesses 
        comparable to coverage for other illnesses, and only two 
        percent have comparable outpatient coverage;
            (5) only two percent of Americans with private health care 
        coverage have policies that adequately and fairly cover severe 
        mental illnesses;
            (6) over 60 percent of health maintenance and preferred 
        provider organizations specifically exclude treatment for those 
        with severe mental illnesses;
            (7) private health insurance provides some type of coverage 
        for 64 percent of all individuals with severe mental illness, 
        but provides only 46 percent of the annual expenditures 
        required for the treatment of severe mental illnesses;
            (8) health care reform plans designed to make health care 
        more accessible and affordable often incorporate the policies 
        that are discriminatory with respect to persons with severe 
        mental illnesses which now exist in common private health 
        insurance plans;
            (9) unequal health insurance coverage contributes to the 
        destructive and unfair stigmatization of persons with severe 
        mental illnesses, illnesses that are beyond the control of the 
        individuals, just like cancer, diabetes, and other serious 
        physical health problems;
            (10) schizophrenia strikes more than 2,500,000 Americans 
        over the course of their lifetimes, and approximately 30 
        percent of all hospitalized psychiatric patients in the United 
        States suffer from this most disabling group of mental 
        disorders;
            (11) left untreated, severe mental illnesses are some of 
        the most disabling and destructive illnesses afflicting 
        Americans;
            (12) studies have found that up to 90 percent of all 
        persons who commit suicide suffer from a treatable severe 
        mental illness, such as schizophrenia, depression, or manic 
        depressive illness;
            (13) some 10 percent of all inmates, or 100,000 people, in 
        prisons and jails in the United States suffer from 
        schizophrenia or manic-depressive psychosis;
            (14) severe mental illness places an individual at high 
        risk for homelessness, as approximately one-third of the 
        Nation's 600,000 homeless persons suffer from severe mental 
        illnesses;
            (15) many persons suffering from severe mental illnesses 
        can be treated effectively but ignorance and stigma continue to 
        prevent many mentally ill individuals from obtaining help;
            (16) seventy to 80 percent of those suffering from 
        depression respond quickly to treatment and 80 percent of the 
        victims of schizophrenia can be relieved of acute symptoms with 
        proper medication;
            (17) about 95 percent of what is known about both normal 
        and abnormal structure and function of the brain has been 
        learned in the last 10 years, but millions of severely mentally 
        ill people have yet to benefit from these startling research 
        advances in clinical and basic neuroscience;
            (18) ensuring adequate health insurance coverage for the 
        treatment of severe mental illnesses can reduce health and 
        societal costs by as much as $2,200,000,000 annually by 
        preventing more costly interventions in the lives of persons 
        with untreated severe mental illnesses and by helping those 
        with severe mental illnesses, many of whom are young adults, 
        remain productive members of society; and
            (19) legislation to reform the health care system should 
        not condone or perpetuate discrimination against persons with 
        severe mental illnesses.

SEC. 3. STATEMENT OF POLICY.

    (a) In General.--It is the policy of the United States that--
            (1) persons with severe mental illnesses must not be 
        discriminated against in the health care system; and
            (2) health care coverage, whether provided through public 
        or private health insurance or any other means of financing, 
        must provide for the treatment of severe mental illnesses in a 
        manner that is equitable and commensurate with that provided 
        for other major physical illnesses.
    (b) Construction.--Subsection (a) shall not be construed to 
preclude the adoption of laws or policies requiring or providing for 
appropriate and equitable coverage for other mental health services.

SEC. 4. NONDISCRIMINATORY AND EQUITABLE HEALTH CARE COVERAGE.

    With respect to persons with severe mental illnesses, to be 
considered nondiscriminatory and equitable under this Act, health care 
coverage shall cover services that are essential to the effective 
treatment of severe mental illnesses in a manner that--
            (1) is not more restrictive than coverage provided for 
        other major physical illnesses;
            (2) provides adequate financial protection to the person 
        requiring the medical treatment for a severe mental illness; 
        and
            (3) is consistent with effective and common methods of 
        controlling health care costs for other major physical 
        illnesses.

SEC. 5. COMMITMENT TO POLICY.

    It is the purpose of this Act to commit the Congress and the 
Executive Branch to incorporating the policy set forth in section 3 
through efforts, including the enactment of legislation, which are 
intended to improve access to or control the costs of health care.

SEC. 6. DEFINITION.

    As used in this Act, the term ``severe mental illness'' means an 
illness that is defined through diagnosis, disability and duration, and 
includes disorders with psychotic symptoms such as schizophrenia, 
schizoaffective disorder, manic depressive disorder, autism, as well as 
severe forms of other disorders such as major depression, panic 
disorder, and obsessive compulsive disorder.

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