[Congressional Record Volume 147, Number 35 (Thursday, March 15, 2001)]
[Senate]
[Pages S2390-S2396]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DODD.
  S. 542. A bill to amend the Harmonized Tariff Schedule of the United 
States to provide separate subheadings for hair clippers used for 
animals; to the Committee on Finance.
  Mr. DODD. Mr. President, I rise to introduce legislation that would 
make a simple correction to our Harmonized Tariff Schedule creating a 
separate subheading for hair clippers used for animals.
  The United States has been engaged in an on-going dispute with the 
European Union, EU, over the EU's refusal to import hormone-treated 
beef from the U.S. In reaction to the EU's failure to comply with a WTO 
ruling that found that this ban on treated beef has been harmful to the 
U.S. economy, the United States Trade Representative issued a list of 
products on which retaliatory duties of 100 percent would be levied. 
Pursuant to Section 407 of the Trade and Development Act of 2000, the 
products designated for retaliatory duties must be related to the 
industries that are affected by the EU's non-compliance with the WTO 
decision.
  One of the many products included on the Trade Representative's list 
is hair clippers. However, no distinction

[[Page S2393]]

is made between those clippers used for animals and those used for 
humans, specifically, beard trimmers. Since both types of clippers are 
grouped within the same subheading under the Harmonized Tariff 
Schedule, human beard trimmers could potentially be subject to 100 
percent duties. Yet, the personal care industry and beard trimmers have 
no relationship to the current beef-hormone dispute as is required by 
Section 407.
  In an effort to prevent this inadvertent application of duties on 
beard trimmers, the bill I am introducing would provide a separate 
subheading for clippers used by animals. I believe that this simple 
clarification will ensure the fair application of our trade laws and 
provide safeguards to U.S. companies and consumers from the unintended 
consequences resulting from these types of trade disputes. I hope my 
colleagues will join me in supporting this legislation.
                                 ______
                                 
      By Mr. DOMENICI (for himself, Mr. Wellstone, Mr. Specter, Mr. 
        Kennedy, Mr. Chafee, Mr. Dodd, Mr. Cochran, Mr. Reed, Mr. Reid, 
        Mr. Warner, Mr. Grassley, Mr. Roberts, Mr. Durbin, and Mr. 
        Johnson):
  S. 543. A bill to provide for equal coverage of mental health 
benefits with respect to health insurance coverage unless comparable 
limitations are imposed on medical and surgical benefits; to the 
Committee on Health, Education, Labor, and Pensions.
  Mr. DOMENICI. Mr. President, I rise today with great pleasure and 
excitement to introduce the ``Mental Health Equitable Treatment Act of 
2001.'' I would also like to thank Senator Wellstone for once again 
joining me to cosponsor this important piece of legislation.
  The human brain is the organ of the mind and just like the other 
organs of our body, it is subject to illness.
  And just as we must treat illnesses to our other organs, we must also 
treat illnesses of the brain.
  Building upon that, I would ask the following question: what if 
thirty years ago our nation had decided to exclude heart disease from 
health insurance coverage?
  Think about some of the wonderful things we would not be doing today 
like angioplasty, bypasses, and valve replacements and the millions of 
people helped because insurance covers these procedures.
  I would submit these medical advances have occurred because insurance 
dollars have followed the patient through the health care system. The 
presence of insurance dollars has provided an enticing incentive to 
treat those individuals suffering from heart disease.
  But sadly, those suffering from a mental illness do not enjoy those 
same benefits of treatment and medical advances because all too often 
insurance discriminates against illnesses of the brain.
  Individuals suffering from a mental illness face this discrimination 
even though medical science is in an era where we can accurately 
diagnose mental illnesses and treat those afflicted so they can be 
productive.
  I simply do not understand, why with this evidence would we not cover 
these individuals and treat their illnesses like any other disease?
  There simply should not be a difference in the coverage provided by 
insurance companies for mental health benefits and medical benefits, 
merely because an individual suffers from a mental illness.
  The introduction of our Bill marks a historic opportunity for us to 
take the next step towards mental health parity. The timing of our Bill 
is even more important because the landmark Mental Health Parity Act of 
1996 will sunset on September 30 of this year.
  As my colleagues know, this is an issue I have a long involvement 
with and I would like to begin with a few observations.
  I believe that we have made great strides in providing parity for the 
coverage of mental illness. However, mental illness continues to exact 
a heavy toll on many, many lives.
  Even though we know so much more about mental illness, it can still 
bring devastating consequences to those it touches; their families, 
their friends, and their loved ones. These individuals and families not 
only deal with the societal prejudices and suspicions hanging on from 
the past, but they also must contend with unequal insurance coverage.
  I would submit the Mental Health Parity Act of 1996 is a good first 
start, but the Act is also not working. While there may adherence to 
the letter of the law, there are certainly violations of the spirit of 
the law. For instance, ways are being found around the law by placing 
limits on the number of covered hospital days and outpatient visits.
  That is why I believe it is time for a change.
  Some will immediately say we cannot afford it or that inclusion of 
this treatment will cost too much. But, I would first direct them to 
the results of the Mental Health Parity Act of 1996. That law contains 
a provision allowing companies to no longer comply if their costs 
increase by more than one percent.

  And do you know how many companies have opted out because their costs 
have increased by more than one percent? Less than ten companies 
throughout our entire country.
  With that in mind I would like to share a couple of facts about 
mental illness with my colleagues:
  Within the developed world, including the United States, 4 of the 10 
leading causes of disability for individuals over the age of five are 
mental disorders.
  In the order of prevalence the disorders are major depression, 
schizophrenia, bipolar disorder, and obsessive compulsive disorder.
  Disability always has a cost and the direct cost to the United States 
per year for respiratory disease is $99 billion, cardiovascular disease 
is $160 billion, and finally $148 billion for mental illness.
  One in every five people, more than 40 million adults, in this Nation 
will be afflicted by some type of mental illness.
  Nearly 7.5 million children and adolescents, or 12 percent, suffer 
from one or more mental disorders.
  Schizophrenia alone is 50 times more common than cystic fibrosis, 60 
times more common than muscular dystrophy and will strike between 2 and 
3 million Americans.
  Let us also look at the efficacy of treatment for individuals 
suffering from certain mental illnesses, especially when compared with 
the success rates of treatments for other physical ailments. For a long 
time, many who are in this field, especially on the insurance side, 
have behaved as if you get far better results for angioplasty than you 
do for treatments for bipolar illness.
  Treatment for bipolar disorders, that is, those disorders 
characterized by extreme lows and extreme highs, have an 80 percent 
success rate if you get treatment, both medicine and care. 
Schizophrenia, the most dreaded of mental illnesses, has a 60-percent 
success rate in the United States today if treated properly. Major 
depression has a 65 percent success rate.
  Lets compare those success rates to several important surgical 
procedures that everybody thinks we ought to be doing:
  Angioplasty has a 41-percent success rate.
  Atherectomy has a 52-percent success rate.

  I would now like to take a minute to discuss the Mental Health 
Equitable Treatment Act of 2001. The Bill seeks a very simple goal: 
provide the same mental health benefits already enjoyed by Federal 
employees.
  The Bill is modeled after the mental health benefits provided through 
the Federal Employees Health Benefits Program, FEHBP, and expands the 
Mental Health Parity Act of 1996 to prohibit a group health plan from 
imposing treatment limitations or financial requirements on the 
coverage of mental health benefits unless comparable limitations are 
imposed on medical and surgical benefits.
  Our Bill provides full parity for all categories of mental health 
conditions listed in the Diagnostic and Statistical Manual of Mental 
Disorders, Fourth Edition, DSM IV, with coverage being contingent on 
the mental health condition being included in an authorized treatment 
plan, the treatment plan is in accordance with standard protocols, and 
the treatment plan meets medical necessity determination criteria.
  Like the Mental Health Parity Act of 1996, the Bill does not require 
a health

[[Page S2394]]

plan to provide coverage for alcohol and substance abuse benefits. 
Moreover, the Bill does not mandate the coverage of mental health 
benefits, rather the Bill only applies if the plan already provides 
coverage for mental health benefits.
  In conclusion, the Bill provides mental heath benefits on par with 
those already enjoyed by Federal employees and I would urge my 
colleagues to support this important piece of legislation.
  I ask unanimous consent that the text of the bill and a summary of 
the bill be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                 S. 543

       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 ``Mental Health Equitable 
     Treatment Act of 2001''.

     SEC. 2. AMENDMENT TO THE EMPLOYEE RETIREMENT INCOME SECURITY 
                   ACT OF 1974.

       (a) In General.--Section 712 of the Employee Retirement 
     Income Security Act of 1974 (29 U.S.C. 1185a) is amended to 
     read as follows:

     ``SEC. 712. MENTAL HEALTH PARITY.

       ``(a) In General.--In the case of a group health plan (or 
     health insurance coverage offered in connection with such a 
     plan) that provides both medical and surgical benefits and 
     mental health benefits, such plan or coverage shall not 
     impose any treatment limitations or financial requirements 
     with respect to the coverage of benefits for mental illnesses 
     unless comparable treatment limitations or financial 
     requirements are imposed on medical and surgical benefits.
       ``(b) Construction.--Nothing in this section shall be 
     construed as requiring a group health plan (or health 
     insurance coverage offered in connection with such a plan) to 
     provide any mental health benefits.
       ``(c) Small Employer Exemption.--
       ``(1) In general.--This section shall not apply to any 
     group health plan (and group health insurance coverage 
     offered in connection with a group health plan) for any plan 
     year of any employer who employed an average of at least 2 
     but not more than 25 employees on business days during the 
     preceding calendar year.
       ``(2) Application of certain rules in determination of 
     employer size.--For purposes of this subsection--
       ``(A) Application of aggregation rule for employers.--Rules 
     similar to the rules under subsections (b), (c), (m), and (o) 
     of section 414 of the Internal Revenue Code of 1986 shall 
     apply for purposes of treating persons as a single employer.
       ``(B) Employers not in existence in preceding year.--In the 
     case of an employer which was not in existence throughout the 
     preceding calendar year, the determination of whether such 
     employer is a small employer shall be based on the average 
     number of employees that it is reasonably expected such 
     employer will employ on business days in the current calendar 
     year.
       ``(C) Predecessors.--Any reference in this paragraph to an 
     employer shall include a reference to any predecessor of such 
     employer.
       ``(d) Separate Application to Each Option Offered.--In the 
     case of a group health plan that offers a participant or 
     beneficiary two or more benefit package options under the 
     plan, the requirements of this section shall be applied 
     separately with respect to each such option.
       ``(e) Definitions.--For purposes of this section--
       ``(1) Financial requirements.--The term `financial 
     requirements' includes deductibles, coinsurance, co-payments, 
     other cost sharing, and limitations on the total amount that 
     may be paid with respect to benefits under the plan or health 
     insurance coverage with respect to an individual or other 
     coverage unit (including annual and lifetime limits).
       ``(2) Medical or surgical benefits.--The term `medical or 
     surgical benefits' means benefits with respect to medical or 
     surgical services, as defined under the terms of the plan or 
     coverage (as the case may be), but does not include mental 
     health benefits.
       ``(3) Mental health benefits.--The term `mental health 
     benefits' means benefits with respect to services for all 
     categories of mental health conditions listed in the 
     Diagnostic and Statistical Manual of Mental Disorders, Fourth 
     Edition (DSM IV-TR), or the most recent edition if different 
     than the Fourth Edition, as defined under the terms of the 
     plan or coverage (as the case may be), if such services are 
     included as part of an authorized treatment plan that is in 
     accordance with standard protocols and such services meet 
     applicable medical necessity criteria, but does not include 
     benefits with respect to the treatment of substance abuse or 
     chemical dependency.
       ``(4) Treatment limitations.--The term `treatment 
     limitations' means limitations on the frequency of treatment, 
     number of visits or days of coverage, or other limits on the 
     duration or scope of treatment under the plan or coverage.''.
       (b) Effective Date.--The amendment made by this section 
     shall apply with respect to plan years beginning on or after 
     January 1, 2002.

     SEC. 3. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT RELATING 
                   TO THE GROUP MARKET.

       (a) In General.--Section 2705 of the Public Health Service 
     Act (42 U.S.C. 300gg-5) is amended to read as follows:

     ``SEC. 2705. MENTAL HEALTH PARITY.

       ``(a) In General.--In the case of a group health plan (or 
     health insurance coverage offered in connection with such a 
     plan) that provides both medical and surgical benefits and 
     mental health benefits, such plan or coverage shall not 
     impose any treatment limitations or financial requirements 
     with respect to the coverage of benefits for mental illnesses 
     unless comparable treatment limitations or financial 
     requirements are imposed on medical and surgical benefits.
       ``(b) Construction.--Nothing in this section shall be 
     construed as requiring a group health plan (or health 
     insurance coverage offered in connection with such a plan) to 
     provide any mental health benefits.
       ``(c) Small Employer Exemption.--
       ``(1) In general.--This section shall not apply to any 
     group health plan (and group health insurance coverage 
     offered in connection with a group health plan) for any plan 
     year of any employer who employed an average of at least 2 
     but not more than 25 employees on business days during the 
     preceding calendar year.
       ``(2) Application of certain rules in determination of 
     employer size.--For purposes of this subsection--
       ``(A) Application of aggregation rule for employers.--Rules 
     similar to the rules under subsections (b), (c), (m), and (o) 
     of section 414 of the Internal Revenue Code of 1986 shall 
     apply for purposes of treating persons as a single employer.
       ``(B) Employers not in existence in preceding year.--In the 
     case of an employer which was not in existence throughout the 
     preceding calendar year, the determination of whether such 
     employer is a small employer shall be based on the average 
     number of employees that it is reasonably expected such 
     employer will employ on business days in the current calendar 
     year.
       ``(C) Predecessors.--Any reference in this paragraph to an 
     employer shall include a reference to any predecessor of such 
     employer.
       ``(d) Separate Application to Each Option Offered.--In the 
     case of a group health plan that offers a participant or 
     beneficiary two or more benefit package options under the 
     plan, the requirements of this section shall be applied 
     separately with respect to each such option.
       ``(e) Definitions.--For purposes of this section--
       ``(1) Financial requirements.--The term `financial 
     requirements' includes deductibles, coinsurance, co-payments, 
     other cost sharing, and limitations on the total amount that 
     may be paid with respect to benefits under the plan or health 
     insurance coverage with respect to an individual or other 
     coverage unit (including annual and lifetime limits).
       ``(2) Medical or surgical benefits.--The term `medical or 
     surgical benefits' means benefits with respect to medical or 
     surgical services, as defined under the terms of the plan or 
     coverage (as the case may be), but does not include mental 
     health benefits.
       ``(3) Mental health benefits.--The term `mental health 
     benefits' means benefits with respect to services for all 
     categories of mental health conditions listed in the 
     Diagnostic and Statistical Manual of Mental Disorders, Fourth 
     Edition (DSM IV), or the most recent edition if different 
     than the Fourth Edition, as defined under the terms of the 
     plan or coverage (as the case may be), if such services are 
     included as part of an authorized treatment plan that is in 
     accordance with standard protocols and such services meet 
     applicable medical necessity criteria, but does not include 
     benefits with respect to the treatment of substance abuse or 
     chemical dependency.
       ``(4) Treatment limitations.--The term `treatment 
     limitations' means limitations on the frequency of treatment, 
     number of visits or days of coverage, or other limits on the 
     duration or scope of treatment under the plan or coverage.''.
       (b) Effective Date.--The amendment made by this section 
     shall apply with respect to plan years beginning on or after 
     January 1, 2002.

     SEC. 4. PREEMPTION.

       Nothing in the amendments made by this Act shall be 
     construed to preempt any provision of State law that provides 
     protections to enrollees that are greater than the 
     protections provided under such amendments.

     SEC. 5. GENERAL ACCOUNTING OFFICE STUDY.

       (a) Study.--The Comptroller General shall conduct a study 
     that evaluates the effect of the implementation of the 
     amendments made by this Act on the cost of health insurance 
     coverage, access to health insurance coverage (including the 
     availability of in-network providers), the quality of health 
     care, and other issues as determined appropriate by the 
     Comptroller General.
       (b) Report.--Not later than 2 years after the date of 
     enactment of this Act, the Comptroller General shall prepare 
     and submit to the appropriate committees of Congress a report 
     containing the results of the study conducted under 
     subsection (a).

[[Page S2395]]

     
                                  ____
         Mental Health Equitable Treatment Act of 2001--Summary

       The Bill seeks to ensure greater parity in the coverage of 
     mental health benefits by prohibiting a group health plan 
     from treating mental health benefits differently from the 
     coverage of medical and surgical benefits.
       The Bill only applies to group health plans already 
     providing mental health benefits and is modeled after the 
     mental health benefits provided through the Federal Employees 
     Health Benefits Program (FEHBP).


                  Full Parity for All Mental Illnesses

       Expands the Mental Health Parity Act of 1996 (MHPA) to 
     prohibit a group health plan from imposing treatment 
     limitations or financial requirements on the coverage of 
     mental health benefits unless comparable limitations are 
     imposed on medical and surgical benefits.
       Provides full parity for all categories of mental health 
     conditions listed in the ``Diagnostic and Statistical Manual 
     of Mental Disorders,'' 4th Edition (DSM IV-TR).
       Coverage is also contingent on the mental health condition 
     being included in an authorized treatment plan, the treatment 
     plan is in accordance with standard protocols, and the 
     treatment plan meets medical necessity determination 
     criteria.
       Defines ``treatment limitations'' as limits on the 
     frequency of treatment, the number of visits, the number of 
     covered hospital days, or other limits on the scope and 
     duration of treatment and defines ``financial requirements'' 
     to include deductibles, coinsurance, co-payments, and 
     catastrophic maximums.


                      Requirements and Exemptions

       Eliminates the September 30, 2001 sunset provision in the 
     MHPA.
       Like the MHPA the bill does not require plans to provide 
     coverage for benefits relating to alcohol and drug abuse.
       There is a small business exemption for companies with 25 
     or fewer employees.
  Mr. WELLSTONE. Mr. President, I am pleased today to join my colleague 
from New Mexico once again to introduce a bill for fairness in health 
coverage for those with mental illness. The Mental Health Equitable 
Treatment Act of 2001 will take the critical next steps to ensure that 
private health insurance companies provide the same level of coverage 
for mental illness as they do for other diseases. This bill will be a 
major step toward ending the discrimination against people who suffer 
from mental illness.
  In 1996, I was proud to introduce the Mental Health Parity Act, a law 
which broke new ground, placing mental health alongside other medical 
and surgical coverage for parity in insurance coverage. Although the 
1996 bill was limited to parity in annual and lifetime limits in care, 
the message was clear: there is no place for discrimination against 
those with mental illness. Since the Mental Health Parity Act became 
law, we have seen that the costs have remained low and manageable, but, 
unfortunately, we have also seen that employers and insurance companies 
have taken advantage of the gaps that remain in coverage for mental 
illness. Patients have faced increases in copayment and deductible 
costs, more problems in gaining access to care, fewer approvals for 
hospital stays and outpatient days, and refusals to cover care. The 
suffering of people with mental illness has grown, and the time to end 
this discrimination is now.
  For too long, mental illness has been stigmatized as a character 
flaw, rather than as the serious disease that it is. As a result, 
people with mental illness are often ashamed and afraid to seek 
treatment, for fear that they will lose their jobs or friends; for fear 
that people will not recognize the suffering that they endure; for fear 
that they will not be able to receive help. We have all seen portrayals 
of mentally ill people as somehow different, as dangerous, or as 
frightening. Such stereotypes only reinforce the biases against people 
with mental illness. Can you imagine this type of portrayal of someone 
who has a cardiac problem, or who happens to carry a gene that 
predisposes them to diabetes? And yet, we have all known someone with a 
serious mental illness, within our families or our circle of friends, 
or in public life. Many people have courageously come forward to speak 
about their personal experiences with their illness, to help us all 
understand better the effects of this illness on a person's life, the 
ways in which effective treatments have helped them, or, sadly, the 
ways in which a loved one died through suicide as a result of untreated 
mental illness. I commend those who speak out on this issue, for their 
honesty and courage to come forward about their experiences, to help 
the world to understand the reality of this disease.
  The statistics concerning mental illness, and the state of health 
care coverage for adults and children with this disease are startling, 
and disturbing. A watershed in our understanding of the impact of 
mental disorders is the 1996 Global Burden of Disease, GBD, study, 
conducted for the World Bank and World Health Organization by experts 
at Harvard University. The GBD defined a very useful concept, called 
the Disability Adjusted Life Year, DALY, which refers to healthy years 
of life lost to either disability or premature mortality. Based on this 
measure of disease burden, mental disorders--which are prevalent 
worldwide, often begin early in life, and frequently are characterized 
by recurrent episodes, as in depression, or chronicity, as in 
schizophrenia, produce a disproportionate share of DALYs, much of which 
is due to the disabling nature of mental illness. According to the GBD 
study, in the U.S. and throughout the developed world, depression is 
the leading cause of disability, and three other mental disorders are 
among the top ten causes of disability, bipolar disorder, 
schizophrenia, and obsessive-compulsive disorder.
  The National Institute of Mental Health, a NIH research institute 
within the U.S. Department of Health and Human Services, describes 
serious depression as an extremely critical public health problem. More 
than 18 million people in the United States will suffer from a 
depressive illness this year, and many will be unnecessarily 
incapacitated for weeks or months, because their illness goes 
untreated. The cost to the nation is in the billions of dollars. The 
suffering of depressed people and their families is immeasurable.
  The situation is worse for children. The 1998 Surgeon General's 
Report on Mental Health estimates that between 5 and 9 percent of those 
under age 18 have mental disorders so severe that they face 
overwhelming difficulties in their efforts to function well with their 
families, friends, and teachers. For children, mental illness carries a 
double burden: both the suffering of the disorder itself, as well as 
the lost period of healthy learning and social development needed to 
help children live up to their potential. The recent tragic episodes of 
violence in our schools remind us that inadequately treated emotional 
and behavioral disorders in our children can literally have lethal 
consequences in terms of suicide and murder.
  Our investment in mental health research is paying off well. We know 
so much more now about brain disease, behavioral and emotional 
disorders, and treatment. But without access to care, such treatments 
cannot help those who are suffering from mental illness. We know from 
NIH-funded research that available medications and psychological 
treatments, alone or in combination, can help 80 percent of those with 
depression. But without adequate treatment, future episodes of 
depression may continue or worsen in severity. Yet, the steady decline 
in the quality and breadth of health care coverage is truly disturbing.
  The inequities related to the status of mental disorders in health 
insurance is indisputable. The U.S. General Accounting Office issued a 
report in May, 2000, that verified that despite passage of the 1996 
mental health parity law, 14 percent of employers failed to comply with 
even the limited protections required by that law. Of the 86 percent 
that did comply, most (87%) continued to limit their mental health 
benefits, thus violating the spirit, if not the letter, of the law. In 
other words, the majority of employers who claim to provide mental 
health benefits restrict actual care through limitations on coverage or 
access, or by increasing the cost to the patient. And they do this 
despite the fact that costs are low. According to most reports on 
parity, including the most recent analysis requested by Congress from 
the National Advisory Mental Health Council, when mental health 
coverage is managed appropriately, premium increases can be as low as 1 
percent.

  Yet inequities in coverage continue, despite the 1996 law and the 
numerous state laws that have tried without success to finally put an 
end to this health care discrimination. The discrimination continues 
despite the fact that there is no biomedical justification for 
differentiating serious mental illness

[[Page S2396]]

from other serious and potentially chronic disorders, nor for judging 
mental disorders to be in any way less real or less deserving of 
treatment. What does exist and continues to grow is an extensive body 
of rigorous research that has demonstrated that treatment for mental 
disorders is both precise and cost-effective.
  Although the costs for coverage have been shown to be low, the 
consequences of untreated mental illness in our society are very 
serious and far-reaching--especially when one looks at how it affects 
individuals, families, employers, corporations, social service systems, 
and criminal justice systems. I have seen first hand in the juvenile 
corrections system what happens when mental illness is criminalized, 
when youth with mental illness are incarcerated for exhibiting symptoms 
of their illness. To treat ill people as criminals is outrageous and 
immoral. We must make treatment for this illness as available and as 
routine as treatment for any other disease. The discrimination must 
stop.
  The Mental Health Equitable Treatment Act of 2001 is modeled after 
the Federal Employees Health Benefit Plan, and provides full parity for 
all categories of mental health conditions. Group health plans would be 
prohibited from imposing treatment limitations, including restricting 
numbers of visits or covered hospital days, or financial requirements, 
such as higher copayments, that are different from other medical/
surgical benefits. This bill is a major step forward in coverage for 
mental illness by private health insurers. It does not require that 
mental health benefits be part of a health benefits package, but 
establishes a requirement for parity in coverage for those plans that 
offer mental health benefits. This bill goes a long way toward our 
bipartisan goal: that mental illness be treated like any other disease 
in health care coverage.
  The Mental Health Equitable Treatment Act of 2001 is designed to take 
a large step toward ending the suffering of those with mental illness 
who have been unfairly discriminated against in their health coverage. 
The time to pass this bill is now.
  Mr. KENNEDY. Mr. President, I am pleased today to join Senator 
Domenici and Senator Wellstone in introducing the Mental Health 
Equitable Treatment Act of 2001. This Act is an important step in the 
fight to end the stigma against mental illness and ensure that those 
suffering from mental illness receive the services they need. For too 
long, individuals with mental disorders have faced unfair treatment 
restrictions and paid more for the services they need than have 
individuals requiring medical or surgical services.
  The groundbreaking report on mental health that the Surgeon General 
released last year reveals that disproportionate cost-sharing 
requirements and treatment limitations ``reduce appropriate use, of 
mental health services,'' and ``leave people to bear catastrophic costs 
themselves.''
  The Mental Health Equitable Treatment Act aims to halt these 
troubling trends by ensuring that group health plans treat mental 
health benefits the same way they do medical and surgical benefits.
  In 1996, we enacted the Mental Health Parity Act. While this 
important legislation made progress in advancing the fair treatment of 
individuals with mental illness, it did not go far enough in providing 
true protection for all people suffering from mental disorders.
  The Mental Health Equitable Treatment Act of 2001 improves upon this 
earlier legislation by providing full parity for a broad range of 
mental health disorders. Under the Act, group health plans must limit 
the treatment restrictions and financial requirements that they impose 
for mental health benefits to the same level that they set for medical 
or surgical benefits. Co-payments for office visits must be comparable, 
for example, regardless of whether the office is a physician's or a 
psychiatrist's. While the Act does not apply to group health plans that 
do not provide any mental health benefits or that have 25 employees or 
less, it is a critical step in ending the blatant discrimination that 
people with mental disorders face in trying to obtain necessary and 
affordable treatment.
  As we have learned more about the brain and the way it works, we have 
developed promising treatments that can significantly improve the 
health of individuals with mental illness and help them lead productive 
lives. Success rates for treating mental illnesses are now as high as 
80 percent. Without strong parity legislation, however, these effective 
treatments will remain elusive for the millions of individuals who need 
them.
  The Mental Health Equitable Treatment Act will finally help these 
individuals receive the care they need by eliminating one of the 
biggest barriers to care, cost. I strongly encourage my colleagues to 
support this groundbreaking piece of legislation.
                                 ______