[Congressional Record Volume 142, Number 115 (Wednesday, July 31, 1996)]
[Senate]
[Page S9292]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             THE MENTALLY ILL AND THE HEALTH INSURANCE BILL

  Mr. DOMENICI. Mr. President, today I was informed by the chairman of 
Labor, Health and Human Services, Senator Nancy Kassebaum, that the 
conferees on the health insurance bill were not going to include--with 
reference to the mentally ill in this country--were not going to 
include even the compromise which had been offered to them that has 
been pending for the last 2 or 3 weeks. Frankly, the U.S. Senate voted 
overwhelmingly to rid this country of a terrible, terrible plight, the 
discrimination against the mentally ill in insurance coverage in this 
country. And not only the discrimination but the lack of fairness and 
parity of coverage.
  I say publicly now to the business community of the United States, in 
particular the large companies, some of which are self-insured--I do 
not say this very often--but ``Shame, shame on you. Shame on you.'' It 
is a very simple proposition of parity that is not going to cost very 
much and will say to the 5 million severely mentally ill Americans and 
their families that they are not going to be treated any longer like 
second-rate, if not third-rate, citizens.
  All we asked of them in our compromise Senator Wellstone and I 
submitted was that if you are going to cover mental illness, if you are 
going to cover mental illness, that you must include two things: One, 
the same lifetime cap that is total coverage, and the same annual 
allowable per year as you include in insurance for everyone else.
  Let me repeat, that amendment did not require any kind of insurance. 
It did not dictate coinsurance, deductibility or anything. So companies 
could still tailor mental health coverage. If they are concerned about 
abuses, they can write the abuses out before they even offer them.
  All we asked for was the simple proposition to get started 
recognizing the discrimination that is in our current situation. That 
is to say, those who are mentally ill, do not cover them with $50,000 
for life while you cover cancer patients with $1 million, do not cover 
the mentally ill with a $100,000 total lifetime if you cover those who 
have tuberculosis or have serious heart trouble with $500,000 or $1 
million. Just parity, total coverage for total lifetime. On an annual 
basis, do not say to those who are mentally ill, you can only collect 
$10,000 a year maximum where you have $100,000 or $50,000 for others.
  I truly believe there is a total lack of willingness to understand 
the nature of this problem. This problem is a blight on America, a 
blight on our insurance companies, and a blight on the business 
community who continues to resist moving in the direction of parity.
  I want to thank those companies in the United States that already 
cover the mentally ill. And there are many. And I can say they are not 
running around complaining about the extraordinary costs. As a matter 
of fact, if this amendment, the one we told them we would settle for, 
were adopted, the increases are almost insignificant according to the 
Congressional Budget Office, because there are not a lot of people who 
will reach those limits. It is just to make sure we do not say to them, 
you are second-rate citizens.
  If you have insurance, your parents bought insurance, they cover 
somebody in their family with schizophrenia, they did not get the shock 
of their life that after they have spent $100,000 they have no more for 
the rest of their life and look around at their neighbor who had a 
heart condition and they get $1 million worth of coverage. No.

  I am not sure where we are going to end up. But I can say that a 
counteroffer was proposed, and I regret to say it was tantamount to a 
whole menu of options. And if you have a menu of options, you are going 
to get nothing, you are going to dump the mentally ill where they are 
already being dumped.
  So I hope that they will reconsider this decision. I, for one, am 
prepared to look, at this moment, at any way I can--I am not sure I can 
succeed--but at any way I can to make it hard to pass that bill. And 
any way I can find to make it impossible to pass that bill, I will do 
it. I am not sure on this conference I will accomplish a great deal, 
but we will make some noise about it because there is no need for this 
decision to go this way.
  If those on the business side will look at the proposed amendment 
that was offered in lieu of the Senate-passed amendment, if they can 
come forth and tell me and tell those who support it how it will hurt 
them, how it is going to cost them, what their problems are, then I 
would be willing to say indeed they are trying to do something fair.
  Thus far, I think it is stubbornness, I think it is totally shameful, 
and I, for one, have been a staunch supporter of making sure we do not 
put undue burdens on business. It is a joke to say they do not want any 
additional mandates when the whole bill is a mandate. The whole bill is 
a mandate. We mandate insurance companies and businesses to pay for 
people with preexisting conditions which is going to cost billions of 
dollars, and they do not talk about that. There is no excuse.
  I, for one, believe we have made a reasonable case. We have been more 
than fair. The millions of Americans suffering from this disgraceful 
discrimination are willing to accept a foot in the door, a little bit, 
just a start, and we get the door slammed right on them.
  Obviously, we have a lot of work to do, but any conferees that are 
unaware of the decision to give the mentally ill people of this country 
nothing in this conference report, maybe they ought to start with the 
conferees. That is what they are about to do.
  Mr. WELLSTONE. I say that the Senator from New Mexico spoke with 
great eloquence and power, and speaks for me.

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