[Congressional Record Volume 150, Number 71 (Wednesday, May 19, 2004)]
[Senate]
[Pages S5730-S5733]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
WELLSTONE MENTAL HEALTH EQUITABLE TREATMENT ACT
Mr. DASCHLE. Mr. President, this past Saturday, thousands of people
in Sioux Falls, SD, and 35 other cities across America, took part in
walks to raise public awareness of mental health. The walks were
sponsored by the National Alliance for the Mentally Ill.
In Sioux Falls, more than 300 people dodged rain showers to walk
through Falls Park. They were different ages, with different
backgrounds. But most shared at least one important distinction: They,
or someone close to them, has a mental illness.
The same is true of nearly all Americans. A 1999 report by the
Surgeon General found that more than 50 million Americans--one in
five--suffer from mental illness each year. Many Members of this
Senate--Republicans and Democrats--have spoken bravely and movingly
about how mental illness has devastated their own parents, children or
siblings.
No Senator who is with us today has demonstrated greater leadership
on issues involving mental health than our distinguished colleague from
New Mexico, Senator Domenici. He knows--from watching a daughter he
loves very much struggle with schizophrenia--that mental illnesses
don't affect just one person; they affect whole families.
Senator Domenici also knows about the stigma attached to mental
illness, and the discrimination and suffering that people with mental
health problems suffer as a result of that stigma.
Almost a decade ago, this proud conservative Republican found a proud
liberal Democratic ally in the Senate. Like Pete Domenici, Paul
Wellstone had seen someone he loved battle a serious mental illness. In
Paul's case, it was his older brother. Pete Domenici and Paul Wellstone
were an ``odd couple.'' But they were fiercely united in their
determination to end discrimination against people with mental illness.
In 1996--thanks to their leadership--Congress passed the Mental
Health Parity Act. The law--for the first time--prevented private
health insurance plans that offer mental health coverage from setting
annual or lifetime limits that are lower than those set for other
illnesses. It was an important step forward. But it left a loophole. It
allowed companies to set much higher deductibles and co-payments for
mental health coverage. It also allowed insurers to set lower limits
for outpatient visits or the number of days of inpatient treatment for
mental illness. As a result, effective, affordable mental health
treatment remains unaffordable for millions of Americans who need it.
The General Accounting Office estimates that nearly 90 percent of the
Nation's health plans engage in legal discrimination based on mental
health diagnoses. The results can be devastating: unemployment, broken
homes, shattered lives, poverty, poor school performance--even suicide.
In 2000, Senator Domenici and Senator Wellstone introduced a new
bill--the Mental Health Equitable Treatment Act--to close the
loopholes. It is a modest proposal. It does not require employers to
provide health insurance. It does not require employers that provide
health insurance to offer mental health coverage. It simply says that,
for employers that choose to offer mental health benefits, insurers
cannot provide more restrictive coverage for mental health benefits
than they do for other medical and surgical benefits.
In late Fall 2001, the Mental Health Equitable Treatment Act was
unanimously added to the Senate version of the FY 2002 Labor HHS
Appropriations bill. But it was stripped out of the final conference
report at the insistence of the White House and the House Republican
leadership.
More than two years ago, in April 2002, President Bush traveled to
New Mexico with Senator Domenici and announced that he supports ``full
mental health parity.'' After listening to families talk about their
mental health horror stories, the President said, ``Americans with
mental illness deserve our understanding and they deserve excellent
care. They deserve a health care system that treats their illness with
the same urgency as physical illness.''
Months later, in late October 2002, Paul Wellstone died in a plane
crash, along with his wife, Sheila, their daughter, Marcia, and four
others. At a memorial service for them in Washington, Senator Domenici
delivered a beautiful eulogy to his friend; he announced that he was
renaming the bill ``The Senator Paul Wellstone Mental Health Equitable
Treatment Act,'' and vowed to pass it.
Despite having 69 Senate co-sponsors, more than a year-and-a-half
after it was re-introduced in this Congress, the Wellstone bill--S.
486--remains stuck in the HELP Committee.
Wellstone Action, the grassroots organization frmed by Paul and
Sheila
[[Page S5731]]
Wellstone's two sons to continue their parents' work, has set passage
of the Wellstone mental health bill as its only legislative goal this
year. Over the last several months, Wellstone Action members have sent
more than 32,000 faxes and letters to Congress asking us to pass the
Wellstone bill.
Bernie Cameron is one of these letter writers. She lives in
Deerfield, NH. Her brother Joe was diagnosed with schizophrenia 50
years ago, when he was just 12. By the age of 14, Joe was living in a
State hospital for children. He has spent a total of only about 5 years
outside of institutions since then.
Bernie Cameron's parents were both Portuguese immigrants who came to
this country when they were 16 years old. Her father worked as a
furniture refinisher. Her mother worked at a shoe store. They had 6
children and never had much money. They visited Joe at least three
times a week.
``Can you imagine visiting your child in a place that smells of
urine, where people are screaming,'' Bernie asks. ``It was so
frustrating to them that they couldn't afford a better place for Joe.''
The powerful medications Joe was prescribed gave him tremors and
other health problems.
In 1983, after Joe's father died, his mother sold the family home.
With the proceeds of the sale, the family sent Joe to McLean's, a very
good private psychiatric hospital in Boston. He was then in his late
40s. The hospital changed Joe's medication, which finally brought his
seizures under control. But, after a year, they told his family there
was nothing else they could do that would make a real difference in the
quality of his life; to much time had been lost.
Before Joe got sick, he was a straight A student. Today, he lives in
a sheltered halfway house. He still has flashes of unusual intellect
and wit. When that happens, his sister wonders, ``If we could have
gotten him into a place like McLean's early on, would it have made a
difference?''
Bernie Cameron calls her brother's story ``a perfect illustration of
the 2-tier health care system in this country.'' If you have insurance
and your illness involves a part of your body other than your brain,
you get health care. But if your brain is affected--even if you have
insurance--there's a good chance you won't get the health care you
need.
A new poll by the Coalition for Fairness in Mental Health Coverage
shows that 83 percent of Americans surveyed support mental health
parity in insurance. When asked whether they would support parity if it
raised the premiums one percent--the high-end cost estimated for the
Wellstone bill--66 percent of Americans continued to say yes.
The Wellstone bill, as I said, has 69 co-sponsors in the Senate, and
245 co-sponsors in the House. It is also supported by more than 360
national organizations.
Mr. President, I ask unanimous consent that the complete list be
printed in the Record at the close of my remarks.
The PRESIDENT pro tempore. Without objection, it is so ordered.
(See exhibit 1.)
Mr. DASCHLE. Yet the Wellstone bill remains stuck in the HELP
Committee because of fierce opposition from the insurance industry and
its allies.
Opponents of mental health parity claim it will drive up the cost of
health coverage, which will result in more people losing their
insurance.
Let me be clear. Their claims are not true. They are scare tactics.
We have heard them all before.
To begin with, small businesses with fewer than 50 employees would be
totally exempt.
In addition, two highly respected organizations have analyzed the
Wellstone bill. The private accounting firm of PricewaterhouseCoopers
predicts it would increase health insurance premiums by 1 percent. That
is it, 1 percent. That works out to $1.32 per month.
The Congressional Budget Office predicts an even smaller average
increase, nine-tenths of 1 percent. I think most families would think
that is a pretty good deal.
Senators Domenici and Wellstone modeled their bill on the mental
health parity provisions in the Federal Employees Health Benefits
Program. According to the Office of Personnel Management, those
provisions have increased FEHB premiums only 1.3 percent, and that
includes treatment for substance abuse which is not part of the
Wellstone bill.
Even these very small cost estimates are probably high because they
do not factor in the cost savings resulting from parity.
The National Institute of Mental Health estimates the cost of
untreated mental illness, including criminal justice and social welfare
costs, at about $300 billion a year.
A 1999 Surgeon General report on mental illness estimates the direct
business costs of lack of parity at $70 billion a year, mostly in
reduced productivity and increased use of sick leave.
By comparison, when workers with depression were treated with
prescription medications, medical costs declined by $882 per employee
per year, and absenteeism dropped by 9 days, according to a study
published in the Health Economics journal.
Why single out people with mental illness to hold down health care
costs? Why not deny treatment for heart disease or diabetes or cancer?
Psychiatric treatment does cost money, but so do heart surgeries,
kidney dialysis, and chemotherapy.
Health insurers are using incorrect and outdated ideas about the
nature and causes of mental illness to deny millions of Americans
essential health care and maximize their profits.
Thirty-four States already have mental health parity laws on the
books, but the laws vary widely. Many cover only a handful of
illnesses, and they cannot cover large, multistate employers or
employers who self-insure. Only a Federal law can guarantee real mental
health parity for all Americans.
Last October, on the first anniversary of the plane crash that killed
Paul and Sheila, their daughter Marcia and four others, I asked
unanimous consent that the Senate take up and pass the Wellstone Mental
Health Equitable Treatment Act. It would have been a perfect tribute to
Paul.
The Republican leadership blocked that request, but they gave us
their word that the Senate would consider the Wellstone mental health
bill early this year. We are now closing in on the Memorial Day recess.
Time is fast running out on this Congress, too. We have been waiting
months now to see a proposed amendment from Senator Gregg and the scope
of the bill.
On June 10, people are coming to Washington from all over America for
a mental health rally to urge passage of the Wellstone bill.
Two years ago in New Mexico, the President said he would work with
Congress to help press a mental health parity bill. The true test of
the President's leadership is not what the President says; it is his
ability to convince Republican leaders in the House and Senate to allow
votes on the bill.
Congress can pass this bill quickly, if the President will help. We
cannot do this alone; we need his help. What we cannot do is allow
mental health benefits to be a luxury only for the very wealthy or the
very fortunate.
I yield the floor.
Mr. REID. Mr. President, before the Senator yields the floor, I would
like to ask him a question through the Chair.
I am happy to hear the statement of the Senator from South Dakota
about the need for mental health parity. One part of me is sad because
when he mentions the name of Paul Wellstone, that presents to me a void
in my life because it seems only yesterday he was back here walking
around with his microphone.
He was a champion of many causes. He worked so hard because he knew I
was interested in the subject of suicide and what causes it and how we
can prevent it.
Even though I know how important this issue is, and we have to do
something about it, I feel--like, I am sure, a lot of his friends who
served in the Senate with him--a real void whenever his name is
mentioned because he truly was one of the most remarkable people I have
met in my life.
I applaud and compliment the leader for his statement on mental
health parity. For this man, it is long overdue to recognize him being
a great Senator.
Mr. DASCHLE. Mr. President, I thank the Senator from Nevada for his
eloquent comments regarding our deceased colleague. I share his
admiration for our departed colleague. He was
[[Page S5732]]
a man who had passion, conviction, and yet a good sense of humor that
allowed that passion and conviction to be embraced by even those who
may not have agreed with him on every issue. But his passion about
mental health, his conviction that it was the right thing for us to do,
to pass mental health parity, lasts way beyond his life. It is not only
in tribute to Paul, but I think in recognition of the appropriateness
of his conviction and his passion that we remind our colleagues of the
debt we owe to him and to our country in passing meaningful legislation
at long last to address this embarrassment and this extraordinary
deficiency in society today.
I again thank the Senator from Nevada and yield the floor.
Exhibit 1
366 Organizations Supporting the Paul Wellstone Mental Health Equitable
Treatment Act
Advocates for Youth, Alaska State Medical Association,
Alliance for Aging Research, Alliance for Children and
Families, Alliance For Mental Health Consumers Rights,
Alzheimer's Association, American Academy of Child and
Adolescent Psychiatry, American Academy of Cosmetic Surgery,
American Academy of Family Physicians, American Academy of
Neurology, American Academy of Ophthalmology, American
Academy of Otolaryngology-Head and Neck Surgery, American
Academy of Pediatrics, American Academy of Physical Medicine
and Rehabilitation, American Academy of Physician Assistants,
American Academy of Psyciatry and the Law, American Academy
of Sleep Medicine, American Association for Geriatric
Psychiatry, American Association for Marriage and Family
Therapy, American Association for Psychosocial
Rehabilitation.
American Association for Thoracic Surgery, American
Association of Children's Residential Centers, American
Association of Clinical Endocrinologists, American
Association of Pastoral Counselors, American Association of
Practicing Psychiatrists, American Association of School
Administrators, American Association of Suicidology, American
Association on Mental Retardation, American Board of
Examiners in Clinical Social Work, American College of
Cardiology, American College of Chest Physicians, American
College of Emergency Physicians, American College of Medical
Genetics, American College of Mental Health Administration,
American College of Nurse-Midwives, American College of
Obstetricians and Gynecologists, American College of
Occupational and Environmental Medicine, American College of
Osteopathic Family Physicians, American College of
Osteopathic Surgeons, American College of Physicians.
American College of Preventive Medicine, American College
of Radiology Association, American College of Surgeons,
American Congress of Community Supports and Employment
Services (ACCSES), American Counseling Association, American
Diabetes Association, American Family Foundation, American
Federation of State, County and Municipal Employees, American
Federation of Teachers, American Foundation for Suicide
Prevention, American Gastroenterological Association,
American Geriatrics Society, American Group Psychotherapy
Association, American Heart Association, American Hospice
Foundation, American Hospital Association, American Humane
Association, American Jail Association, American Managed
Behavioral Healthcare Association (AMBHA), American
Medical Association.
American Medical Directors Association, American Medical
Group Association, American Medical Rehabilitation Providers
Association, American Medical Student Association, American
Mental Health Counselors Association, American Music Therapy
Association, American Network of Community Options and
Resources, American Nurses Association, American Occupational
Therapy Association, American Orthopaedic Foot and Ankle
Society, American Orthopsychiatric Association, American
Osteopathic Academy of Orthopedics, American Osteopathic
Association, American Pediatric Society, American Political
Science Association, American Psychiatric Association,
American Psychiatric Nurses Association, American
Psychoanalytic Association, American Psychological
Association, American Psychotherapy Association.
American Public Health Association, American School
Counselor Association, American School Health Association,
American Society for Adolescent Psychiatry, American Society
for Clinical Pathology, American Society of Addiction
Medicine, American Society of Anesthesiologists, American
Society of Clinical Oncology, American Society of Clinical
Pharmacology, American Society of Plastic Surgeons, American
Therapeutic Recreation Association, American Thoracic
Society, America's Health Together, Anna Westin Foundation,
Anorexia Nervosa and Related Eating Disorders, Inc., Anxiety
Disorders Association of America, Arizona Medical
Association, Arkansas Medical Society, Association for the
Advancement of Psychology, Association for Ambulatory
Behavioral Healthcare.
Association for Clinical Pastoral Education, Inc.,
Association for Science in Autism Treatment, Association of
American Medical Colleges, Association of Asian Pacific
Community Health Organizations, Association of Jewish Aging
Services of North America, Association of Jewish Family &
Children's Agencies, Association of Maternal and Child Health
Programs, Association of Medical School Pediatric Department
Chairs, Association of Orthopaedic Foot and Ankle
Surgeons, Association of University Centers on
Disabilities, Association to Benefit Children, Attention
Deficit Disorders Association, Autism Society of America,
Barbara Schneider Foundation, Bazelon Center for Mental
Health Law, Brain Injury Association of America, Inc.,
California Medical Association, Camp Fire USA, The Carter
Center, Catholic Charities USA.
Center for the Advancement of Health, Center for Women
Policy Studies, Center on Disability and Health, Center on
Juvenile and Criminal Justice, Central Conference of American
Rabbis, Chicago Public Schools, Child & Adolescent Bipolar
Foundation, Child Neurology Society, Children and Adults with
Attention-Deficit/Hyperactivity Disorder, Children's Defense
Fund, Children's Healthcare Is a Legal Duty, Children's
Hospital Boston, Child Welfare League of America, Christopher
Reeve Paralysis Foundation, Church of the Brethren Washington
Office, Clinical Social Work Federation, Coalition for
Juvenile Justice, College of Psychiatric and Neurologic
Pharmacists, Colorado Medical Society, Commission on Social
Action of Reform Judaism.
Connecticut State Medical Society, Corporation for the
Advancement of Psychiatry, Council for Exceptional Children,
Council of State Administrators of Vocational Rehabilitation,
Council on Social Work Education, County of Santa Clara, CA,
Cure Autism Now, Dads and Daughters, Depression and Bipolar
Support Alliance, Disability Rights Education and Defense
Fund, Inc., Disability Service Providers of America, Disabled
American Veterans, Division for Learning Disabilities (DLD)
of the Council for Exceptional Children, Easter Seals, Eating
Disorders Coalition for Research, Policy & Action, Employee
Assistance Professionals Association, Epilepsy Foundation,
Families For Depression Awareness, Families USA, Family
Violence Prevention Fund, Family Voices, Federation of
American Hospitals.
Federation of Behavioral, Psychological & Cognitive
Sciences, Federation of Families for Children's Mental
Health, Florida Medical Association, Freedom From Fear,
Friends Committee on National Legislation (Quaker), Harvard
Eating Disorders Center, Hawaii Medical Association, Human
Rights Campaign, Idaho Medical Association, Illinois State
Medical Society, Inclusion Research Institute, Indiana State
Medical Association, Institute for the Advancement of Social
Work Research, International Association of Jewish Vocational
Services, International Association of Psychosocial
Rehabilitation Services, International Community Corrections
Association, International Dyslexia Association,
International Society of Psychiatric-Mental Health Nurses,
International Spinal Injection Society, Iowa Medical Society.
Iris Alliance Fund, Jewish Federation of Metropolitan
Chicago, Johnson Institute, Joint Council of Allergy, Asthma
and Immunology, Kentucky Medical Association, Kids Project,
Kristen Watt Foundation for Eating Disorder Awareness, Latino
Behavioral Health Association, Learning Disabilities
Association of America, Legal Action Center, Louisiana State
Medical Society, Lutheran Ofc. for Governmental Affairs,
Evangelical Lutheran Church in America, Lutheran Services in
America, Maine Medical Association, Massachusetts Medical
Society, MedChi, the Maryland State Medical Society, Medical
Association of Georgia, Medical Association of the State of
Alabama, Medical Group Management Association, Medical
Society of Delaware.
Medical Society of the District of Columbia, Medical
Society of New Jersey, Medical Society of the State of New
York, Medical Society of Virginia, Medicare Rights Center,
MentalHealth AMERICA, Inc., Michigan State Medical Society,
Minnesota Medical Association, Mississippi State Medical
Association, Missouri State Medical Association, Montana
Medical Association, NAADAC, The Association for Addiction
Professionals, National Advocacy Center of the Sisters of the
Good Shepherd, National Alliance for Austism Research,
National Alliance for the Mentally Ill, National Alliance for
Research on Schizophrenia and Affective Disorders,
National Alliance to End Homelessness, National Asian
American Pacific Islander Mental Health Association,
National Asian Women's Health Organizations, National
Assembly of Health and Human Service Organizations.
National Association for the Advancement of Colored People
(NAACP), National Association for the Advancement of
Orthotics & Prosthetics, National Association for Children's
Behavioral Health, National Association for the Dually
Diagnosed, National Association for Medical Direction of
Respiratory Care, National Association for Rural Mental
Health, National Association of Anorexia Nervosa and
Associated Disorders--ANAD, National Association of Case
Management, National Association of Children's Hospitals,
National Association of Community Health Centers, National
Association of Counties, National Association of County
Behavioral Health Directors, National Association of County
and City Health
[[Page S5733]]
Officials, National Association of Development Disabilities
Councils, National Association of Mental Health Planning &
Advisory Councils, National Association of Pediatric Nurse
Practitioners, National Association of Protection and
Advocacy Systems, National Association of Psychiatric Health
Systems, National Association of School Nurses, National
Association of School Psychologists.
National Association of Social Workers, National
Association of State Directors of Special Education, National
Association of State Mental Health Program Directors,
National Center for Policy Research for Women & Families,
National Center on Institutions and Alternatives, National
Coalition Against Domestic Violence, National Coalition for
the Homeless, National Coalition of Mental Health Consumers
and Professionals, National Committee to Preserve Social
Security and Medicare, National Council for Community
Behavioral Healthcare, National Council of Jewish Women,
National Council of La Raza, National Council on the Aging,
National Council on Alcoholism and Drug Dependence, National
Council on Family Relations, National Council on Problem
Gambling, National Council on Suicide Prevention, National
Down Syndrome Congress, National Down Syndrome Society,
National Eating Disorders Association.
National Educational Alliance for Borderline Personality
Disorder, National Education Association, National Exchange
Club Foundation, National Foundation for Depressive Illness,
National Health Council, National Health Law Program,
National Hispanic Medical Association, National Hopeline
Network, National Housing Conference, National Latino
Behavioral Health Association, National Law Center on
Homelessness & Poverty, National Leadership on African
American Behavioral Health, National League of Cities,
National Medical Association, National Mental Health
Association, National Mental Health Awareness Campaign,
National Mental Health Consumers' Self-Help Clearinghouse,
National Multiple Sclerosis Society, National Network for
Youth, National Organization for Rare Disorders.
National Organization of People of Color Against Suicide,
National Organization on Fetal Alcohol Syndrome, National
Osteoporosis Foundation, National Partnership for Women and
Families, National PTA, National Recreation and Park
Association, National Rural Health Association, National
Schizophrenia Foundation, National Senior Citizens Law
Center, National Therapeutic Recreation Society, National
Treatment and Research Advancements Association for
Personality Disorder, Native American Counseling Inc.,
Nebraska Medical Association, NETWORK, a Catholic Social
Justice Lobby, Nevada State Medical Association, New
Hampshire Medical Society, New Mexico Medical Society, NISH
(National Industries for the Severely Handicapped), North
american Association of Masters in Psychology, North Carolina
Medical Society.
North Dakota Medical Association, Obsessive Compulsive
Foundation, Office & Professional Employees International
Union, Ohio State Medical Association, Oklahoma State Medical
Association, Older Adult Consumer Mental Health Alliance,
Oregon Medical Association, Organization of Student Social
Workers, Partnership for Recovery, Pennsylvania Medical
Society, People For the American Way, People With
Disabilities Foundation, Physicians for Social
Responsibility, Presbyterian Church (USA), Washington Office,
Prevent Child Abuse America, Rebecca Project for Human
Rights, Renfrew Center Foundation, Rhode Island Medical
Society, Samaritans Suicide Prevention Center, School Social
Work Association of America.
Screening for Mental Health, Inc., Service Employees
International Union, Shaken Baby Alliance, Sjogren's Syndrome
Foundation, Society for Adolescent Medicine, Society for
Pediatric Research, Society for Personality Assessment,
Society for Public Health Education, Society for Research
on Child Development, Society for Social Work Research,
Society for Women's Health Research, Society of American
Gastrointestinal Endoscopic Surgeons, Society of Medical
Consultants to Armed Forces, Society of Professors of
Child and Adolescent Psychiatry, Society of Thoracic
Surgeons, South Carolina Medical Association, South Dakota
State Medical Association, STOP IT NOW!, Suicide Awareness
Voice of Education, Suicide Prevention Action Network USA,
Tennessee Medical Association.
Texas Medical Association, The Arc of the United States,
Title II Community AIDS National Network, Tourette Syndrome
Association, Treatment and Research Advancements Association
for Personality Disorder, Union of American Hebrew
Congregations, Unitarian Universalist Association of
Congregations, United Cerebral Palsy Association, United
Church of Christ, Justice and Witness Ministry, United Jewish
Communities, United Methodist General Board of Church and
Society, Utah Medical Association, Vermont Medical Society,
Volunteers of America, Washington State Medical Association,
Wellstone Action, West Virginia State Medical Association,
Wisconsin Medical Society, Working Assets, Women of Reform
Judaism, Wyoming Medical Society, Yellow Ribbon Suicide
Prevention Program, Youth Law Center.
____________________