[Congressional Record Volume 148, Number 113 (Tuesday, September 10, 2002)]
[Senate]
[Pages S8425-S8427]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         MENTAL ILLNESS PARITY

  Mr. WELLSTONE. Mr. President, the Washington Post on September 9 had 
an editorial titled ``Equity for Mental Illness.'' I ask unanimous 
consent this editorial be printed in the Record.
  There being no objection, the editorial was ordered to be printed in 
the Record, as follows:

             [From the Washington Post, September 9, 2002]

                       Equity for Mental Illness

       Last spring President Bush announced a new commitment to 
     improving mental health care for Americans. He cited unfair 
     limits on treatment as one major obstacle to effective care 
     and pledged to seek legislation by year's end to require that 
     insurance plans treat mental illnesses in the same way they 
     treat other medical ailments. Now time is getting short and 
     the calendar is crowded, but Congress still should approve a 
     parity bill, and Mr. Bush, recalling his pledge, should help 
     make it happen.
       This isn't the position we took when we last examined the 
     subject, last year, and many of the issues that troubled us 
     then haven't disappeared. Parity legislation is not a 
     panacea. It won't help the uninsured. There's a risk that, by 
     raising costs, it could cause some employers to weaken or 
     abandon existing coverage or charge employees more for 
     benefits. Congress tends to be much more interested in 
     providing benefits than in dealing with their costs: That's 
     especially true for a mandate like this, in which the costs 
     would be borne almost entirely by the private sector. 
     Businesses wrestling with double-digit increases in health 
     care costs are fighting any move that would add even 
     marginally to the problem.
       But two factors now seem to us to outweigh those concerns. 
     The first is practical: Experience in both the federal 
     employees' insurance system and in states that have enacted 
     their own parity laws argues that, by managing care, insurers 
     can move toward equal treatment without crippling cost 
     increases. The Congressional Budget Office has estimated that 
     enacting the parity bill now pending in Congress would add 
     just less than one percent to the overall national cost of 
     insurance premiums, though specific costs will vary from 
     business to business depending on what benefits are offered. 
     Insurers, CBO noted this spring, still will be able to 
     exercise the management tools that have been used in the past 
     to decide what treatments are appropriate and warranted, and 
     to hold down expenses. The right response to the gathering 
     health care crisis is to fix the system, not make the 
     mentally ill bear a disproportionate burden.
       The second factor is one of fundamental fairness, and of 
     removing the stigma that for too long has shrouded mental 
     illness. Many mental disorders can be clearly diagnosed and 
     effectively treated; some can't. The same can be said of 
     cancers. The pending legislation would require large 
     employers who offer coverage for mental and other illness to 
     handle all disorders in essentially the same way: You can't 
     put treatment limits or financial requirements on mental 
     health benefits that are not imposed on physical ailments. 
     Insurers would not have to pay for what is not medically 
     effective. It's not a huge step, but it would help some 
     people get the treatment they need. It's right to level the 
     field.
  Mr. WELLSTONE. I will read the opening paragraph:

       Last spring President Bush announced the new commitment to 
     improving mental health care for Americans. He cited unfair 
     treatment as one major obstacle to effective care and pledged 
     to seek legislation to require the insurance plans to treat 
     mental illness in the same way they treat other medical 
     ailments. Now time is getting short and the calendar is 
     crowded, but Congress still should approve a parity bill, and 
     Mr. Bush, recalling his pledge, should help make it happen.
       This isn't the position we took when we last examined the 
     subject.

  As a coauthor of this legislation with Senator Domenici, I am 
gratified and moved that the Washington Post has come out with a very 
strong editorial in favor of parity in mental health coverage. This 
legislation is called the Mental Health Equity Treatment Act, with, by 
the way, 67 Senators, two-thirds of the Senate, and 243 
Representatives, including authors Marge Roukema and Patrick Kennedy, 
bipartisan in both the Senate and the House, in support of it.
  The Washington Post says it is not a be-all or end-all. The 
Washington Post is absolutely right. But it at least is a huge step 
toward ending the discrimination. And more or less, I argue, once we 
have the coverage in the plans, the care will follow the money. And 
there will be more of an infrastructure of care for people who do not 
get any help.
  I don't know what has happened with the negotiations. There is no 
stronger advocate than my colleague, Senator Domenici. I was excited 
when the President announced his support. I thought the White House 
would bring people together and we would have agreement in the House 
and the Senate and we would pass legislation. Frankly, I have not seen 
a lot of negotiation take place. It has been a huge disappointment to 
me. I hope the White House will become fully engaged. It is not too 
late.
  The President went on record as saying: I want to see this 
legislation passed; I want to see this discrimination ended. We need to 
see those words backed by action.
  What we call the Mental Health Equity Treatment Act has tremendous 
support. If the White House would become engaged in this, we can pass 
this legislation. There are any number of different vehicles we still 
have this month. I believe we can attach this legislation to one of 
those vehicles and one of those appropriations bills or other pieces of 
legislation. This legislation will pass. It will pass for a couple of 
reasons. It will pass because all of the families that have been 
affected by this illness--and there is not anybody in the Senate or the 
House who does not have a member of the family who has not been 
affected one way or the other--have stepped forward. They have become 
their own leaders. They have become their own citizen lobby. They 
basically say it is time to end this discrimination. This is major 
civil rights legislation.
  It will pass. Last time, this became part of the Education, Labor, 
Health and Human Services appropriations bill. Both Senator Harkin and 
Senator Specter were strong advocates of this matter when it went to 
conference committee. We had near unanimous support in the Senate. Then 
it was blocked last session by the House Republican leadership and the 
White House. But there were a number of Republicans who said: We are 
very uncomfortable voting against this. Several of them, I believe, 
have their own personal experiences in their own families or with 
friends with mental illness. Several of them said: Look, if this comes 
back a year later and nothing has been done, we do not want to vote 
against this.

  I come to the floor to include this very important editorial in the 
Washington Post in the Senate Record to bring this to my colleagues' 
attention. This is a change of position on the part of the Washington 
Post. The Washington Post points this out in their editorial.
  Second, I remind the President that he has made a commitment to 
helping pass this legislation this session, not to put it off year 
after year after year. I hope he will back his words with the deed, the 
good Hebrew word, ``mitzvah.''
  Time is not neutral. We do not have a lot of time yet. There is a lot 
of good will in the Senate, both by Democrats and Republicans. 
Certainly, one of the key leaders is Senator Domenici. Nobody has done 
more. I mention Marge Roukema and Patrick Kennedy on the House side. 
Senator Reid has done so much work. I could go on and on. The White 
House has been semi-missing in action. We need them to become engaged. 
I have no doubt we can pass this

[[Page S8426]]

in the Senate either on its own or as part of this appropriations bill 
or another bill. I worry there would be an effort to block it.
  I think the President can do something wonderful. I think he can do 
something very positive. I think not only would he get a tremendous 
amount of support in the Senate and the House, but he would get a lot 
of support from families and people all across the country.
  For my own part, working with my colleague, Senator Domenici, I am 
ready to put this amendment on to a bill. I am ready to do that. 
Certainly, we are going to do that in the Senate. We are going to get 
this into a conference committee. If we get the support from the 
President, we will pass this legislation. It would be win-win-win.
  The insurance industry will not love it. That is true. They will not 
be in love with it. But it will be a win for the White House for doing 
something very good for people. It will be a win for both Democrats and 
Republicans, Republicans and Democrats. Most important of all, it will 
make a positive difference in the lives of many families and many 
people across this country.
  Let's get this done. Let's get the support from the White House. Mr. 
President, you said you were all for this. We need you. We need you to 
be engaged. We need you to exert leadership. We need your support. If 
we get your support, we will pass this legislation.
  As we look toward September 11, and commemorate this tragic day in 
America's history, we can be proud of the way in which the American 
people rallied to support those who suffered such unspeakable losses in 
their lives. Many of us still feel the shock and the fear of that day, 
and while we can take great pride in the ways in which our country has 
recovered, we know that for many, the grief and the trauma is still 
sharp and constant. We know more about how such events can leave scars 
on the psyche of a country, as well as individuals. We know that many 
who had suffered from mental illness prior to September 11 may find 
they need treatment again. We know that many in New York and other 
parts of our country are suffering from post-traumatic stress disorder. 
We show our strength as Americans when we respond not only with our 
strength and outrage toward the perpetrators of this horror, but also 
with compassion and support toward the victims.
  I was pleased to sponsor support for programs that provided emergency 
mental health care for survivors and emergency workers and their 
families in the Senate's bioterrorism bill and other legislation. But 
we know that more is needed to improve the overall infrastructure of 
mental health care in our country's response to terrorism. People with 
mental illness are routinely denied decent mental health care. They are 
required to pay more for their care, and are given less access, simply 
because their illness is located in the brain, and not in another part 
of the body. While we can be proud as a country for our ongoing fight 
to reduce stigma against the mentally ill, we here in Congress should 
not be so proud. Nor should the President. We have not yet done our job 
in truly helping those with mental illness by ensuring full mental 
health parity in insurance coverage.
  The Mental Health Equitable Treatment Act, which I have sponsored 
with Senator Pete Domenici, is poised to pass in this congress. This 
bill is more than ready to move forward and to be signed by the 
President. S. 543 enjoys the support of two-thirds of the Senate, 67 
Senators, the majority of the House, 243 Representatives, and about 250 
organizations representing health care, education, law enforcement, 
disability, religious organizations, and many others. On June 6, more 
than 2,000 people rallied at the Capitol in 100 degree heat to demand 
that this legislation move forward. On April 29, President Bush 
publicly proclaimed his support for full mental health parity and vowed 
to work with Congress to make sure he signed a full mental health 
parity bill this year.
  And today, the Washington Post, which has historically questioned the 
value of mental health parity, reversed its position in support of full 
mental health parity. The Post states on its editorial page, ``Now time 
is getting short and the calendar is crowded, but Congress still should 
approve a bill, and Mr. Bush, recalling his pledge, should help make it 
happen.''
  Throughout this Congress, I have continued to work with Senator 
Domenici, and with Senator Kennedy, who, as Chair of the HELP 
committee, has been so helpful in moving this bill forward. Senator 
Daschle has stated many times that this legislation is one of the 
priority issues for the Senate floor. I have worked with White House 
staff to help clarify the intention of Congress in shaping this 
legislation--that we expect it to be a comprehensive bill that does not 
discriminate against people by diagnosis. We have been open and 
available to discussing issues of concern to other members and the 
White House. But we are still waiting? Why? Because the opponents of 
this bill--the insurance industry--continue to try to influence their 
friends at the White House and on Capitol Hill to either kill this 
bill, or weaken it so much that it would provide very little help to 
those who are praying for its passage.
  Every argument the opponents have tried to put forward--whether it is 
cost, or science, or treatment effectiveness--every one of these 
arguments has been fought and won by the supporters of this bill. 
Opponents have challenged the CBO cost estimate of this bill not once, 
not twice, but three times, to no avail. The cost of S. 543 is low: the 
estimated increase in premiums for full mental health parity, covering 
all diagnoses, is 0.9 percent.
  The opposition also distorts the purpose and intention of the bill by 
trying to limit it to only 5 percent of mental illness diagnoses. They 
know there is no scientific or even economic basis for restricting 
coverage in this way, but they continue these destructive methods as 
one more way to try to kill the bill. They resort to ridicule by 
trivializing the pain and reality of mental illness and the toll it 
takes on the lives of those with this illness and their families. This 
is an outrage, and we cannot allow such tactics to destroy the 
democratic process.

  We all are very aware of how much work is remaining on our Senate 
calendar, much of which is so important to our country. But here, in 
this piece of legislation, we can show true bipartisan support, along 
with solidarity with the President, for those with mental illness. This 
bill will help those with chronic mental illnesses, those with acute 
depression, anxiety, or PTSD resulting from the trauma of September 11, 
children with autism or eating disorders, and the millions of other 
Americans with mental illness. Without treatment, mental illness can 
worsen, and can even lead to death. We cannot as a country allow people 
with mental illness to be treated as second-class citizens any longer. 
As the Post said today,``The right response to the gathering health 
care crisis is to fix the system, not make the mentally ill bear a 
disproportionate burden.''
  When President Bush spoke in support of full mental health parity, we 
in the Senate had already done our job. We had invested many months in 
bipartisan meetings to shape a bill that respected the business 
community, the insurance industry, and the needs of those with mental 
illness. This is why this bill has the support of the majority of 
Congress and about 250 organizations who represent millions of 
Americans.
  It is time for President Bush to speak again, to publicly support 
this bipartisan, bicameral bill that clearly has the support of the 
American people. The House has finally held hearings on this, and I 
want to thank those committees for doing so. The hearings made it 
possible for witnesses to expose the arguments of the insurance 
industry for what they are. The opposition is based on nothing more 
than discrimination and protecting the corporate bottom line.
  I want President Bush to be confident that he has my continued 
support to do everything possible to pass this legislation. But I ask 
him now to follow through on the promise he made in New Mexico to 
support full mental health parity. This legislation is ready to move 
forward. The President asked to sign a full mental health parity bill. 
There is nothing stopping this bill except the politics of the 
insurance industry. I ask President Bush to put the needs of those 
suffering from mental illness first, to help prevent further suffering 
and deaths, and to ease the

[[Page S8427]]

pain of those scarred by September 11 by helping to make treatment 
available to those who need it. I ask him to urge Republican 
Congressional leaders to support this legislation. I ask him to endorse 
S. 543/H.R. 4066.
  Within the constraints of the Senate calendar, this bill may move 
forward independently, or we may again attach it to an appropriations 
bill, as we did last year. With the tremendous support for this bill on 
and off the Hill, we have these options. However, when the bill moved 
forward on LHHS appropriations in 2001, 10 House members voted to kill 
this bill, and President Bush wrote a letter to Senator Domenici 
promising to help pass it this year. I ask the President to follow 
through on that promise. I ask him to prevent the insurance lobby from 
killing this bill again. Our country needs this legislation, and the 
majority of Americans have made it clear that they want it now.
  I look forward to the day when people with mental illness receive 
decent, humane, and timely mental health care. It will be a good day 
for our country. I ask the President to make sure that this day comes 
soon.
  Mr. DASCHLE. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The Presiding Officer. Without objection, it is so ordered.

                          ____________________