[Congressional Record Volume 151, Number 163 (Saturday, December 17, 2005)]
[House]
[Pages H12125-H12128]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                MENTAL HEALTH BENEFITS PARITY EXTENSION

  Mr. BOEHNER. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 4579) to amend title I of the Employee Retirement Income 
Security Act of 1974, title XXVII of the Public Health Service Act, and 
the Internal Revenue Code of 1986 to extend by one year provisions 
requiring parity in the application of certain limits to mental health 
benefits.
  The Clerk read as follows:

                               H.R. 4579

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

     SECTION 1. ONE-YEAR EXTENSION FOR PROVISIONS REQUIRING PARITY 
                   IN THE APPLICATION OF CERTAIN LIMITS TO MENTAL 
                   HEALTH BENEFITS.

       (a) Amendment to the Employee Retirement Income Security 
     Act of 1974.--Section 712(f) of the Employee Retirement 
     Income Security Act of 1974 (29 U.S.C. 1185a(f)) is amended 
     by striking ``December 31, 2005'' and inserting ``December 
     31, 2006''.
       (b) Amendment to the Public Health Service Act.--Section 
     2705(f) of the Public Health Service Act (42 U.S.C. 300gg-
     5(f)) is amended by striking ``December 31, 2005'' and 
     inserting ``December 31, 2006''.
       (c) Amendment to the Internal Revenue Code of 1986.--
     Section 9812(f)(3) of the Internal Revenue Code of 1986 
     (relating to application of section) is amended by striking 
     ``December 31, 2005'' and inserting ``December 31, 2006''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Ohio (Mr. Boehner) and the gentleman from California (Mr. George 
Miller) each will control 20 minutes.
  The Chair recognizes the gentleman from Ohio.


                             General Leave

  Mr. BOEHNER. Mr. Speaker, I ask unanimous consent that all Members

[[Page H12126]]

may have 5 legislative days within which to revise and extend their 
remarks and include extraneous material on H.R. 4579.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Ohio?
  There was no objection.
  Mr. BOEHNER. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, the bill will extend provisions under ERISA, the Public 
Health Services Act and the Internal Revenue Code regarding mental 
health parity for 1 year until December 31, 2006.

         Committee on Education and the Workforce, House of 
           Representatives,
                                Washington, DC, December 17, 2005.
     The Hon. Joe Barton,
     Chairman, Committee on Energy and Commerce, Washington, DC.
       Dear Chairman Barton: I write regarding our mutual 
     understanding for the consideration of H.R. 4579, a bill 
     amending the Employee Retirement Income Security Act (ERISA), 
     the Public Health Service Act (PHSA), and the Internal 
     Revenue Code (IRC) to extend certain provisions on mental 
     health benefits. The provisions of this bill amending ERISA 
     are within the sole jurisdiction of the Committee on 
     Education and the Workforce. The provisions of this bill 
     amending PHSA are within the sole jurisdiction of the 
     Committee on Energy and Commerce. The provisions of this bill 
     amending IRC are within the sole jurisdiction of the 
     Committee on Ways and Means.
       As you and I understand the importance of extending the 
     provisions to each of these Acts, we have agreed to the 
     scheduling of this bill for consideration in the House of 
     Representatives. However, I agree that we have done so only 
     with the understanding that this procedural route should not 
     be construed to prejudice the jurisdictional interest and 
     prerogatives of the Committee on Education and the Workforce, 
     the Committee on Ways and Means, or the Committee on Energy 
     and Commerce, respectively, on these provisions or any other 
     similar legislation, and will not be considered as precedent 
     for consideration of matters of jurisdiction to each 
     committee in the future. Finally, I would support your 
     request for appointment of conferees on the provisions in 
     your Committee's jurisdiction should a conference arise with 
     the Senate.
       A copy of our exchange of letters will be inserted in the 
     Congressional Record on this bill. Thank you for your 
     consideration and cooperation in this matter.
           Sincerely,
                                                  John A. Boehner,
     Chairman.
                                  ____

         Committee on Education and the Workforce, House of 
           Representatives,
                                Washington, DC, December 17, 2005.
     The Hon. Bill Thomas,
     Chairman, Committee on Ways and Means, Washington, DC.
       Dear Chairman Thomas: I write regarding our mutual 
     understanding for the consideration of H.R. 4579, a bill 
     amending the Employee Retirement Income Security Act (ERISA), 
     the Public Health Service Act (PHSA), and the Internal 
     Revenue Code (IRC) to extend certain provisions on mental 
     health benefits. The provisions of this bill amending ERISA 
     are within the sole jurisdiction of the Committee on 
     Education and the Workforce. The provisions of this bill 
     amending PHSA are within the sole jurisdiction of the 
     Committee on Energy and Commerce. The provisions of this bill 
     amending IRC are within the sole jurisdiction of the 
     Committee on Ways and Means.
       As you and I understand the importance of extending the 
     provisions to each of these Acts, we have agreed to the 
     scheduling of this bill for consideration in the House of 
     Representatives. However, I agree that we have done so only 
     with the understanding that this procedural route should not 
     be construed to prejudice the jurisdictional interest and 
     prerogatives of the Committee on Education and the Workforce, 
     the Committee on Ways and Means, or the Committee on Energy 
     and Commerce, respectively, on these provisions or any other 
     similar legislation, and will not be considered as precedent 
     for consideration of matters of jurisdiction to each 
     committee in the future. Finally, I would support your 
     request for appointment of conferees on the provisions in 
     your Committee's jurisdiction should a conference arise with 
     the Senate.
       A copy of our exchange of letters will be inserted in the 
     Congressional Record on this bill. Thank you for your 
     consideration and cooperation in this matter.
           Sincerely,
                                                  John A. Boehner,
     Chairman.
                                  ____

                                         House of Representatives,


                                  Committee on Ways and Means,

                               Washington, DC., December 17, 2005.
     Hon. John A. Boehner,
     Chairman, Committee on Education and the Workforce, 
         Washington, DC.
       Dear Chairman Boehner: I am writing concerning H.R. 4579, a 
     bill ``To amend title I of the Employee Retirement Income 
     Security Act of 1974, title XXVII of the Public Health 
     Service Act, and the Internal Revenue Code of 1986 to extend 
     by one year provisions requiring parity in the application of 
     certain limits to mental health benefits,'' which was 
     introduced on December 16, 2005, and referred to the 
     Committee on Education and the Workforce, and in addition to 
     the Committee on Energy and Commerce and the Committee on 
     Ways and Means.
       As you know, the Committee on Ways and Means has 
     jurisdiction over matters concerning the Internal Revenue 
     Code. Section 1 of H.R. 4579 amends Section 9812(f)(3) of the 
     Internal Revenue Code of 1986 providing for an extension of 
     parity in the application of certain limits to mental health 
     benefits, and thus falls within the jurisdiction of the 
     Committee on Ways and Means. However, in order to expedite 
     this legislation for floor consideration, the Committee will 
     forgo action on this bill. This is being done with the 
     understanding that it does not in any way prejudice the 
     Committee with respect to the appointment of conferees or its 
     jurisdictional prerogatives on this or similar legislation.
       I would appreciate your response to this letter, confirming 
     this understanding with respect to H.R. 4579, and would ask 
     that a copy of our exchange of letters on this matter be 
     included in the Congressional Record during floor 
     consideration.
           Best regards,
                                                      Bill Thomas,
                                                         Chairman.

  Mr. Speaker, I reserve the balance of my time.
  Mr. GEORGE MILLER of California. Mr. Speaker, I yield such time as he 
may consume to the gentleman from Rhode Island (Mr. Kennedy).
  Mr. KENNEDY of Rhode Island. Mr. Speaker, I thank the gentleman from 
California for yielding me time, and I thank the chairman as well.
  Mr. Speaker, what we are doing here today is simply renewing an act 
that will allow mental health insurance to have the same limits in 
insurance coverage as every other insurance legislation that you would 
ever have for a physical illness. However, the problem is that we keep 
doing this each year without addressing the fundamental problem. The 
fundamental problem is that we have here in the Congress a bill that 
would require parity in insurance coverage, meaning equal copay, equal 
deductible, equal premium for those illnesses, for those mental 
illnesses, when it comes to insurance coverage as there would be for 
any other physical illness.
  Mr. Speaker, I have two major illnesses. I have asthma, which is a 
chronic illness; and I have an EpiPen, and I have prednisone, and I 
also have bipolar disorder, and I have Prozac and I have lithium.
  Now, I am fortunate enough to have insurance coverage where when I go 
to get my coverage for my medications, I do not have to pay a higher 
copay for my mental health drugs as opposed to my asthma drugs. Do you 
know why? Because the Congress of the United States has mental health 
parity. Yes, Members of Congress are not discriminated against when it 
comes to mental illnesses.
  However, you in the public out there in America, when you try to go 
and try to get treatment for bipolar disorder, for schizophrenia, for 
major depression, for any number of mental illnesses, you are told you 
have to pay a higher copay, a higher deductible, and you are told that 
you have to pay a higher premium on top of that, all because this 
country still treats mental illness as if it is not a physical illness.
  Mr. Speaker, I have a chart here that shows that mental illness is a 
physical illness, for those that do not truly believe it. Here we can 
see in what is an x-ray called a PET scan the difference between two 
brains, each differentiating from the other based upon a difference in 
the disorder that the illness represents. In this case, we have bipolar 
disorder, and you can see that there is greater activity in one part of 
the brain here for those that do suffer from it, as opposed to this 
brain.
  The physical qualities of mental illness are well known, so why do we 
not have parity in this country? Well, we do not have parity because 
some think that it is going to cost us more money.
  Well, the tests are in, the studies have been done, and, quite 
frankly, to my colleagues who think that this is going to cost the 
Chamber of Commerce more money, all they need to do is look at The Wall 
Street Journal for evidence to the fact that it actually saves 
businesses money. It saves businesses money because it costs us $31 
billion a year, $31 billion a year in productivity lost because 
businesses do not ensure adequate coverage for their employees in 
mental illness.

[[Page H12127]]

  Just understand this: anyone who has depression, are you truly able 
to make it at work and focus on what you are doing? That is called 
presenteeism. That is when you are at work, but you really are not at 
work because you cannot concentrate. That is called presenteeism. Then, 
of course, you have absenteeism. Of course, that is easy to measure.
  The fact, my friends, is that an average person who has depression 
loses 5 hours a week of productivity compared to one that does not. So 
would you not think that some mental health coverage for the person 
suffering from depression might actually improve productivity?
  Guess what? It does. The studies are in, and, frankly, that is why I 
cannot understand why the majority of this House has not even brought 
to the floor of this House a mental health parity bill that will allow 
us to end the discrimination that currently exists in this country.
  We are sanctioning discrimination. We are basically saying, like, for 
example, cancer, well, we are not going to cover cancer because it is 
costing too much. That is essentially what we are being told by those 
who do not want to cover mental illness. We are basically being told 
``your illness costs money.''
  Well, if it is about saving money, why not just cut out cancer 
coverage, because, you know, that costs us a lot of money. That is a 
foolish argument. And equally as foolish is the fact that we would cut 
out from insurance coverage mental illness simply because of 
stereotypes and because of stigma in this country.

                              {time}  1730

  This legislation today is simply one part of a farce to make people 
think that we are actually doing something on mental health parity 
when, in fact, with this legislation what we are doing today, all it 
does is allow the insurance companies to play the game where they do 
not actually have to provide the coverage. They can organize various 
days that actually can be utilized and the number of appointments that 
someone can have or the kind of drugs that they are prescribed. This 
legislation might as well have been written by the insurance industry 
when it comes to coverage for those with mental illness.
  So, Mr. Speaker, let me just conclude by stating a few facts. Those 
who are 65 or older are the highest rate of suicide in this country; 65 
and older have the highest rate of suicide in this country. The third 
leading cause of death for young people is suicide. This year alone we 
are going to see 1,400 young people take their lives in colleges and 
universities in this country.
  We are not taking this issue, this illness, seriously enough. And if 
it pulls your heart strings and it is simply about whether you think it 
is going to save money or not, you can see from these charts that even 
the Surgeon General of the United States has said that mental illnesses 
comprise the second leading cause of morbidity, meaning the lost days 
in life, productive life; and the World Health Organization has ranked 
it number one.
  So how could we be so blind to look at such a significant part of our 
health care system and then just look the other way when it comes to 
insurance coverage?
  I hope my good friend from California will help me in getting his 
leadership to help bring to the floor of the House a parity bill that 
will allow us to finally end the stigma and discrimination that still 
exists in this country towards those with mental illness.
  Let me just say, with respect to our veterans coming back and 
suffering from post-traumatic stress disorder, when we say that we are 
not going to cover mental illness, we are making an implicit message 
out there to America that somehow it is not real, somehow it is not 
real health care, it is something on the order of cosmetic surgery. You 
know what that does? That means that there will be fewer veterans 
coming forward and asking for help. Ninety-six percent of the veterans 
coming back from Iraq right now are not signing up for any mental 
health consultation whatsoever. And the reason they are not is because 
of the stigma.
  And by not bringing a bill like parity to the floor, another thing 
that we do that is unjust is we reinforce the image in America that if 
you are mentally ill there is something wrong with you, that you ought 
to just get up, pull yourself up by you bootstraps, and you ought to 
get with the program, and that it is some moral failure of yours as 
opposed to it actually being a physical disorder with its roots in the 
biology of the brain.
  I thank the chairman and my good friend, the ranking member from 
California, for giving me this time to speak. There is so much here to 
discuss. I would not have all the time that I would need to discuss it. 
But hopefully if we do get a parity bill on the floor one of these 
days, we can have an even fuller discussion of this issue.
  Mr. GEORGE MILLER of California. Mr. Speaker, I yield myself such 
time as I may consume.
  Mr. Speaker, I thank the gentleman for his statement but, more 
importantly, his incredible advocacy on behalf of those suffering from 
mental health diseases.
  He is quite right: we can do better than simply renewing this law 
that is now 10 years old. The Senate did pass a meaningful update in 
this law in 2001 that would have prohibited all forms of discriminatory 
coverage of mental health services, including day and visit limitations 
and co-pays and deductibles, and would not allow a plan to opt out by 
citing increased costs. This bill simply does not do that.
  It is as the gentleman from Rhode Island has pointed out, it is 
absolutely insufficient in terms of treating the needs of millions and 
millions of Americans and their families who need parity in terms of 
the kinds of treatment and the coverages of the cost that are 
associated with this.
  Mr. Speaker, I yield back the balance of my time.
  Mr. BOEHNER. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, I want to thank my colleague from Rhode Island for his 
moving testimony today on the issue of mental health. I would be the 
first to agree that the mental health parity bill that we have will 
now, as Mr. George Miller of California says, and has for the last 10 
years been an important step in the right direction.
  Is it enough for most people? Probably not. And I think that all of 
us are aware that Congress and the American people have been in this 
debate for a long time. We have 45 million Americans who have no health 
insurance at all, and we know that every time we mandate a benefit on 
employers' insurance policies, we raise the cost of those policies. And 
what is the result of higher health insurance policies? More uninsured 
Americans.
  So there is a balance, and I realize that people want more mental 
health coverage. The debate will continue here in the Congress; but in 
the meantime, I think it is important for us to make sure that the 
mandate that is in the current law that does provide some coverage for 
mental health illness that is going to expire will do so unless we 
extend this provision. And that is all the bill before us does is 
extend the provisions already in law to make sure that at least there 
is a foundation of coverage in the law as people have come to expect.
  Mr. DINGELL. Mr. Speaker, I am pleased to support H.R. 4579, 
legislation that would continue for a year the requirements that 
insurance companies provide mental health services on the same par as 
health services. Discrimination against those with mental illnesses or 
cognitive impairments is well documented. Treatment for these 
conditions can last a lifetime. Not surprisingly, insurance companies 
do not want to provide coverage for needed treatments.
  The bill we are passing today would ensure that coverage for mental 
health care receives parity with coverage for physical conditions. The 
current requirement expires at the end of the year. While ideally we 
should make this a permanent feature for all health insurance policies, 
today we are only extending it for one year.
  While this legislation will ensure some protections for Americans, 
the House-passed reconciliation bill includes provisions that would 
reduce coverage for mental health care under Medicaid. That bill would 
allow States to charge higher out-of-pocket costs to those needing 
these services and it would allow States to strip these benefits for 
beneficiaries, including from children. Medicaid accounts for 44 
percent of the Nation's public mental health spending. It plays a 
critical role in protecting those who need mental and behavioral health 
services, and fills the gaps that private insurance does not cover.

[[Page H12128]]

  While the bill today will offer some protections for individuals with 
mental health needs in private insurance, we also must ensure that the 
budget reconciliation bill does not erode protections in Medicaid, 
which provides coverage for those for whom private insurance coverage 
is not enough or those who have no private insurance.
  Mr. BOEHNER. Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Boozman). The question is on the motion 
offered by the gentleman from Ohio (Mr. Boehner) that the House suspend 
the rules and pass the bill, H.R. 4579.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the bill was passed.
  A motion to reconsider was laid on the table.

                          ____________________