[Congressional Record (Bound Edition), Volume 154 (2008), Part 1]
[House]
[Pages 1482-1487]
[From the U.S. Government Publishing Office, www.gpo.gov]




  EXTENDING PARITY IN APPLICATION OF CERTAIN LIMITS TO MENTAL HEALTH 
                                BENEFITS

  Mr. PALLONE. Madam Speaker, I move to suspend the rules and pass the 
bill (H.R. 4848) to extend for one year parity in the application of 
certain limits to mental health benefits, and for other purposes, as 
amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 4848

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

     SECTION 1. PARITY IN APPLICATION OF CERTAIN LIMITS TO MENTAL 
                   HEALTH BENEFITS.

       (a) Amendment to the Internal Revenue Code of 1986.--
     Section 9812(f)(3) of the Internal Revenue Code of 1986 is 
     amended by striking ``2007'' and inserting ``2008''.
       (b) 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 ``2007'' and inserting ``2008''.
       (c) 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 ``2007'' and inserting ``2008''.

     SEC. 2. INCLUSION OF MEDICARE PROVIDERS AND SUPPLIERS IN 
                   FEDERAL PAYMENT LEVY AND ADMINISTRATIVE OFFSET 
                   PROGRAM.

       (a) In General.--Section 1874 of the Social Security Act 
     (42 U.S.C. 1395kk) is amended by adding at the end the 
     following new subsection:
       ``(d) Inclusion of Medicare Provider and Supplier Payments 
     in Federal Payment Levy Program.--
       ``(1) In general.--The Centers for Medicare & Medicaid 
     Services shall take all necessary steps to participate in the 
     Federal Payment Levy Program under section 6331(h) of the 
     Internal Revenue Code of 1986 as soon as possible and shall 
     ensure that--
       ``(A) at least 50 percent of all payments under parts A and 
     B are processed through such program beginning within 1 year 
     after the date of the enactment of this section;
       ``(B) at least 75 percent of all payments under parts A and 
     B are processed through such program beginning within 2 years 
     after such date; and
       ``(C) all payments under parts A and B are processed 
     through such program beginning not later than September 30, 
     2011.
       ``(2) Assistance.--The Financial Management Service and the 
     Internal Revenue Service shall provide assistance to the 
     Centers for Medicare & Medicaid Services to ensure that all 
     payments described in paragraph (1) are included in the 
     Federal Payment Levy Program by the deadlines specified in 
     that subsection.''.
       (b) Application of Administrative Offset Provisions to 
     Medicare Provider or Supplier Payments.--Section 3716 of 
     title 31, United States Code, is amended--
       (1) by inserting ``the Department of Health and Human 
     Services,'' after ``United States Postal Service,'' in 
     subsection (c)(1)(A); and
       (2) by adding at the end of subsection (c)(3) the following 
     new subparagraph:
       ``(D) This section shall apply to payments made after the 
     date which is 90 days after the enactment of this 
     subparagraph (or such earlier date as designated by the 
     Secretary of Health and Human Services) with respect to 
     claims or debts, and to amounts payable, under title XVIII of 
     the Social Security Act.''.
       (c) Effective Date.--The amendments made by this section 
     shall take effect on the date of the enactment of this Act.

     SEC. 3. DEPOSIT OF EXCESS SAVINGS IN PAQI FUND.

       (a) In General.--In addition to any amounts otherwise made 
     available to the Physician Assistance and Quality Initiative 
     Fund under section 1848(l)(2) of the Social Security Act (42 
     U.S.C. 1395w-4(l)(2)), there shall be made available to such 
     Fund--
       (1) $93,000,000 for expenditures during or after 2009;
       (2) $212,000,000 for expenditures during or after 2014; and
       (3) $44,000,000 for expenditures during or after 2018.
       (b) Obligation.--The Secretary of Health and Human Services 
     shall provide for expenditures from the Fund specified in 
     subsection (a) in a manner designed to provide (to the 
     maximum extent feasible) for the obligation of the entire 
     amount specified in--
       (1) subsection (a)(1) for payment with respect to 
     physicians' services furnished during or after January 1, 
     2009;
       (2) subsection (a)(2) for payment with respect to 
     physicians' services furnished on or after January 1, 2014; 
     and
       (3) subsection (a)(3) for payment with respect to 
     physicians' services furnished on or after January 1, 2018.

     SEC. 4. PROTECTION OF SOCIAL SECURITY.

        To ensure that the assets of the trust funds established 
     under section 201 of the Social Security Act (42 U.S.C. 401) 
     are not reduced as a result of the enactment of this Act, the 
     Secretary of the Treasury shall transfer from the general 
     revenues of the Federal Government to those trust funds the 
     following amounts:
       (1) For fiscal year 2008, $1,000,000.
       (2) For fiscal year 2009, $5,000,000.
       (3) For fiscal year 2010, $1,000,000.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. Pallone) and the gentleman from Pennsylvania (Mr. Tim 
Murphy) each will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. PALLONE. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days to revise and extend their remarks and 
include extraneous material on the bill under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. Madam Speaker, I yield myself such time as I may 
consume.
  I rise to urge support for this bill which was developed jointly by 
the Energy and Commerce Committee, the Ways and Means Committee, and 
the Education and Labor Committee. This bill would extend the Mental 
Health Parity Act of 1996, the first-ever Federal parity law.
  Over 10 years ago, Congress passed and President Clinton signed into 
law legislation that required partial parity by mandating that annual 
and lifetime dollar limits for mental health treatment under group 
health plans offering mental health coverage be no less than that for 
physical illnesses. This legislation was authorized for 5 years, and 
has been extended every year with bipartisan support since its initial 
authorization expired. The bill before us would extend the Mental 
Health Parity Act for another year. I urge my colleagues on both sides 
of the aisle to support its passage.
  Madam Speaker, let me also say that while the 1996 law was a good 
first step, we clearly have much further to go before we can achieve 
full mental health parity. That is why it is imperative that we pass 
H.R. 1424, the Paul Wellstone Mental Health Parity and Addiction Equity 
Act of 2007, introduced by my colleagues Representative Patrick Kennedy 
and Representative Jim Ramstad. I want to congratulate and thank both 
of them. Mr. Kennedy will be speaking shortly in favor of his 
legislation.
  In spite of the 1996 law and widespread recognition that mental 
illness

[[Page 1483]]

and substance abuse are treatable illnesses, there still exist glaring 
inequities between health insurance coverage for mental health and that 
for other medical conditions. As we all know, these inequities can have 
dire consequences for friends, families and society in general. H.R. 
1424 will take our Nation one step further to ensuring that every 
American can access the mental health, substance abuse and addiction 
treatment that they need to live healthy, happy and productive lives.
  Madam Speaker, by putting mental health on par with medical and 
surgical benefits, we will be improving the availability and 
affordability of health care for those who suffer from mental health 
illnesses and addiction diseases. This will not only reduce the pain 
and anguish of many of our constituents and their families, but will 
benefit our Nation as a whole. So let's extend the good work that has 
already been done and work together to build upon the framework so that 
we can improve the lives of millions of Americans.
  I reserve the balance of my time, Madam Speaker.
  Mr. TIM MURPHY of Pennsylvania. Madam Speaker, I yield myself as much 
time as I may consume.
  We're gathered here today to debate or support H.R. 4848, a bill 
which extends that which Congress has passed before, and that was an 
important bill for its time. It's an important bill to extend for, in 
doing so, we acknowledge the innate value of helping those suffering 
from mental illness. We 
acknowledge in Congress that for those who suffer these afflictions, 
they may be relieved of that suffering through receiving necessary 
treatment.
  In compassion, we as a body extend our hand in support of those who 
suffer the pains of mental illness. We acknowledge that their illnesses 
are real, and that the appropriate treatments give them hope to slough 
off the yoke of their illness and again become a fully productive 
member of our Nation, our workplace and our family.
  The significance of this act may be overshadowed by other events of 
the day, but it is essential that we not fail to appreciate the value 
of this moment, not only in terms of what this bill does but what it 
does not do and, moreover, why we need to enact this law at all.
  First to the reasons for this bill. As John Adams said, ``Our 
Constitution was made only for a moral and religious people. It is 
wholly inadequate to the government of any other.''
  He made that comment not because our Constitution is a vehicle to 
support any particular religion; rather, he noted the inherent 
inadequacies of any body of laws, and that they cannot replace the 
moral light that should guide us when no law has yet been writ to 
define that path.
  Indeed, we cannot legislate common sense, we cannot mandate morality, 
and we cannot litigate compassion. We can, however, establish laws to 
define the limits of what can be tolerated. And where the laws do not 
apply, we hope that the goodness and faith that guides our hearts is 
sufficient to drive us to do the right thing.
  Unfortunately, when it comes to dealing with mental illness, our 
society, our culture and our government has failed to do the right 
thing. We have spent billions, hundreds of billions, I dare say, over 
the years to help those with mental illness, but we have remained 
short-sighted at best, or blind at worst as to what we truly must do.
  It is my wish that people would be personally guided by their own 
sense of justice and compassion to do the right thing in the treatment 
of mental illness. Instead, we remain willfully and woefully ignorant 
to the causes, the diagnoses, and the treatment of mental illness. We 
have denied its very existence, perhaps wasting our hope in the hope it 
would go away. We have instead tried to wish away its effects. We have 
minimized the impact, trivialized the causes, and criticized the 
patients. We have used words to make mental illness the butt of cruel 
jokes. We have used words like ``crazy'' or ``retarded'' or ``idiot,'' 
as if attaching a derogatory label would free us from the 
responsibility for helping or treating those with these illnesses.
  I ask you: Would we use such disparaging remarks to describe persons 
with cancer, with diabetes, with heart disease? Could demeaning words 
make any of those diseases disappear or less painful? Can derisive 
words motivate someone to seek help? No, instead they drive the person 
further into the shadows to deny their own illness, to avoid treatment 
and not even help themselves.
  In many ways, we have not advanced very far beyond the days of the 
Salem witch trials when those with mental illness were ignorantly tried 
as criminals, sentenced to death, or cruelly treated with torture.
  Think this is not true today? Well, think again. Our prisons are 
filled with persons who suffer from mental illness. Our courts are 
packed with victims of child abuse or sex abuse. Our churches are 
filled with those who are praying to be relieved of the terrible 
strains befalling them. Families break up. Jobs are lost. Children fail 
in school and lives are lost from untreated mental illness. And yet we 
continue to deny it is there and place barriers between the patient and 
the cure.
  In my many years of practicing psychology, I have never, never met a 
patient who was cured by denial. But denial is the common treatment for 
so many when it comes to acknowledging or treating mental illness.
  Listen, you cannot whisper it away, for even in the silence, even in 
the darkness, mental illness cries out for help.
  One in five Americans will suffer from a diagnosable mental illness. 
One in 10 young people suffer from mental illness severe enough to 
cause some form of impairment.
  Untreated drug and alcohol addictions cost Americans $400 billion 
each year. A Rand study estimated that depression alone cost employers 
$51 billion per year in absenteeism and lost productivity.
  Suicide is the eighth leading cause of death in the United States. 
More years of life are lost to suicide than any other single cause 
except heart disease and cancer.
  Thirty thousand Americans commit suicide annually, and half a million 
attempt it. Among college students, three die each day from suicide.
  The Federal Government estimates that about 12\1/2\ million people 
have alcohol problems. It costs businesses $134 billion a year in lost 
productivity.
  Does treatment work to help people with mental illness? Yes, it does. 
Studies of depression in the workplace have shown thousands of dollars 
of savings per employee when they receive treatment.
  We note that when 80 percent of health care costs are used to treat 
chronic illness, that the risk for depression doubles among those who 
are chronically ill and not receiving treatment. The cost doubles as 
well.
  The combination of appropriate medication and treatments have been 
very effective in treating anxiety, depression, bipolar illness and 
behavior disorders. But when health plans do not pay for appropriate 
professional care, where does the treatment come from?
  Seventy-five percent of psychiatric medications are prescribed by 
non-psychiatrists. Now look at that in the context of other illnesses. 
Would we tolerate it if 75 percent of insurance plans said that most 
babies would be delivered by people with minimal training? How about 
requiring that brain surgery is done by those who only had a few weeks 
of training in medical school. Would we accept that? We would not.
  This bill extends what we have done before. It helps in a small but 
important way. But it does not move us to where we need to be. Perhaps 
the lesson here is that there are many things we need to do for 
ourselves, many things we need to do to reach out to others and help. 
But it does not cure the barriers. It does not identify which diagnoses 
need to be treated. We will need to do more. Eventually we as a Nation 
need to come to terms with what needs to be done. The cost savings of 
providing the right treatment are huge. The costs of continuing to 
provide the wrong care, or denying care, are massive.
  As Benjamin Franklin said, ``By failing to prepare, you are preparing 
to fail.''

[[Page 1484]]

  Madam Speaker, I reserve the balance of my time.
  Mr. PALLONE. Madam Speaker, I yield 3 minutes to the gentleman from 
Rhode Island (Mr. Kennedy), who has probably done more to address the 
issue of mental health parity than any Member of Congress. He actually 
came to my district, we had a hearing on the issue, and I really 
appreciate all that he has done on the issue.
  Mr. KENNEDY. I thank Chairman Pallone for his work in bringing the 
extension of this mental health parity law to the floor. I want to 
acknowledge his help on H.R. 1424, the Paul Wellstone Mental Health and 
Addiction Act, and say I join him in saying today is a great start in 
us extending this law on lifetime and annual limits. But, as he 
mentioned, we want to get full parity, which means we want to get the 
real bill that extends full coverage of mental illnesses to all health 
insurance plans. Just as we would expect health insurance plans to 
cover the rest of our body, cancer, diabetes, everything else, we 
shouldn't expect any less for mental illnesses.
  And yet, unlike many other physical illnesses, mental illnesses are 
excluded from most health insurance plans. In fact, 98 percent of our 
health insurance plans in America charge higher copays and deductibles 
for mental illnesses simply because of stigma, simply because of 
discrimination.

                              {time}  1630

  Because of the shame and because Americans are too afraid to say that 
they are willing to say enough is enough, and they're not willing to 
say that's wrong, and they're not going to sit idly by while insurance 
companies say that they can get away with it, we in the Congress ought 
to stand up and say, enough is enough. We are going to pass the law 
that says civil rights matter in this country, and if you are born with 
a mental illness, just as if you were born with any kind of physical 
disability, you should not be discriminated against. And that is what 
we mean when we say we want to pass the Paul Wellstone Mental Health 
and Addiction Equity Act. We can't afford any more days without this 
law.
  As my good friend said over here, each year 1.3 billion workdays are 
lost due to mental disorders, more than any other, arthritis, stroke, 
heart attack, or cancer combined.
  We cannot afford one more day without parity because the Department 
of Justice estimates that drug-related crime costs our Nation $107 
billion a year. We cannot afford one more day without parity because 80 
percent of the trauma-related admissions in our emergency rooms in this 
country are drug- and alcohol-related, implicated in car accidents, 
shootings, stabbings, and domestic and violent incidences, as well as 
overdoses.
  We cannot afford one more day without parity because workers' 
untreated depression cost their employers $31 billion a year in lost 
productivity and cost their employers $135 billion in lost productivity 
just due to alcoholism alone.
  I will tell you this: We are paying for this in so many other ways, 
we cannot afford not to spend the money on treatment up front.
  But the fact of the matter is, insurance companies continue to deny 
treatment. Just take one case of Katie Kevlock, a 16-year-old from 
Pennsylvania. The insurance company said to her, It is not enough that 
you came in here hooked on heroin. We need to see you overdose before 
we are going to give you treatment coverage.
  Guess what her mother said? Well, I'm not sure my daughter's got an 
overdose in her before I can bring her back for her treatment.
  Well, guess what? She, of course, overdosed, and she didn't survive 
that overdose. But that's what that insurance company demanded. They 
demanded that she have an overdose before she qualified for treatment, 
but she didn't survive that overdose. She died like millions of other 
Americans, and that is the cost of us not providing treatment.
  Treatment works. Recovery works. We need to end the stigma of mental 
illness and addiction in our society. That's why we need to pass H.R. 
1424, the Paul Wellstone Mental Health and Addiction Equity Act; and 
that's why we need to extend the bill today to provide one more year of 
annual lifetime limits for the current parity law.
  Mr. TIM MURPHY of Pennsylvania. Madam Speaker, I appreciate the 
compassion and passion of my friend from Rhode Island who has been such 
a leader in mental health parity.
  I yield such time as he may consume to the gentleman from New Jersey 
(Mr. Ferguson), another great leader whose heart goes out to those in 
need of mental health issues.
  Mr. FERGUSON. Madam Speaker, I want to thank the gentleman from 
Pennsylvania for the time. I want to thank Chairman Pallone for his 
work on this legislation as well.
  I rise today in support of H.R. 4848. This important legislation will 
extend the current mental health parity laws to individuals that 
desperately need coverage and care.
  Madam Speaker, I dare say every single one of us in this Chamber, and 
probably everyone we know, knows someone, cares about someone, perhaps 
a member of our very own family, who has faced the challenge of mental 
illness and who could benefit from additional mental health coverage.
  Thousands and thousands of people suffer from mental health illnesses 
and addictions in our country. My family is no different from any other 
family who maybe has a loved one or a member of that family who has 
dealt with these very significant and difficult problems. This 
legislation would continue bringing much-needed treatment to those who 
are in such need.
  Addictions and mental illnesses are afflictions that have long been 
stigmatized and brushed aside by our society and our institutions. Not 
only is this societal perception deterring many individuals from 
seeking and receiving much-needed treatment, but also the lack of 
insurance coverage for such treatments prevents many individuals from 
gaining access to the critical help and the treatments that they need.
  Many individuals go months or maybe even years without treatment for 
serious illnesses due to the stigma that our society has placed on 
these serious diseases. They feel like they must hide their illness 
from their friends or their family while trying to lead a normal life.
  However, these illnesses and the individuals who suffer from them 
deserve care and treatment just as if they were suffering from some 
other illness or disease. The victims of mental illness should no 
longer have to suffer in silence and in secret.
  For too long, people have been told they must take care of themselves 
while battling these diseases and illnesses. Those battling their 
debilitating effects haven't been able to receive the stability of care 
that's available when adequate health insurance coverage is in place.
  The legislation we are considering today takes steps in the right 
direction by continuing the current mental health parity laws. However, 
current laws are not perfect, and they need to be amended to improve 
the health care of mental addictions and illnesses in our country.
  I have been a proud cosponsor of the mental health parity efforts in 
the past, and I will continue to be an ardent supporter of these 
efforts to have full mental health parity in America. I support 
legislation that was already mentioned, the Paul Wellstone Mental 
Health and Addiction Equity Act, which is legislation that would make 
full mental health parity the law of the land. This legislation is 
needed, and it should have been passed long ago.
  This legislation has been championed by my good friend Patrick 
Kennedy, the Member from Rhode Island, who we just heard from. He's 
been such a leader on this effort, and he and Jim Ramstad of Minnesota, 
from our side of the aisle, have really worked so hard and so 
diligently on this legislation. I really believe that through their 
work, and the work of many of us, we will help to deliver what people 
battling addiction and mental illness have long needed and want; that 
is, the help that they need.
  We have to continue to ensure that every individual has access to the

[[Page 1485]]

health care coverage that they need. Every single individual that's 
affected by these sicknesses should not be without mental health 
coverage in our country.
  I urge my colleagues to support H.R. 4848 to continue to provide 
mental health coverage to the thousands of individuals who are so 
desperately in need of that help.
  Mr. PALLONE. Madam Speaker, I yield 3 minutes to the gentleman from 
Maryland (Mr. Sarbanes).
  Mr. SARBANES. Madam Speaker, I want to thank my colleague 
Representative Pallone on his work on H.R. 4848 which is important for 
us to support because it does extend certain mental health coverages. 
But as we've all been saying here today, it is just as important that 
we continue to work very hard to enact and pass H.R. 1424, which is the 
Paul Wellstone Mental Health and Addiction Equity Act, and I want to 
salute Representatives Ramstad and Kennedy for their tremendous work on 
this bill.
  Mental health parity is the right thing to do. Clearly, there are so 
many individuals and families that are in pain in this country because 
they are not receiving the mental health counseling services, the 
substance abuse and addiction treatment services that they deserve and 
that our society ought to provide to them.
  But it is also the smart thing to do. All of the statistics, even if 
you just wanted to look at this through the cold, calculating lens of 
what the bottom line represents in terms of cost to our system and our 
society, all of the studies that have been done show that there are 
tremendous savings to be had if we focus on these kinds of service.
  There have been many statistics that have been cited today. I will 
cite a few more. Depressed workers lose 5\1/2\ hours per week of 
productive work time. That adds up to tens of billions of dollars lost 
a year to employers. Alcohol-related illness and premature death cost 
over $130 billion in lost productivity in 1998, and the statistics go 
on and on and on.
  Even the most tightfisted insurer will discover very quickly once we 
have mental health parity in place that the costs are a lot and that, 
in fact, there are savings to be had as you reallocate dollars to 
mental health treatment and substance abuse treatment in terms of the 
savings in related medical treatment.
  So it is absolutely the right thing to do, and particularly at this 
time when we have so many stories of returning veterans who are 
suffering from traumatic brain injury, from mental health issues and 
need the support that can come from this, from this larger bill, from 
the Paul Wellstone Act.
  So I urge my colleagues to support this extension through H.R. 4848 
of certain mental health coverages, but I join all those who are 
advocating very strongly that we move forward and enact the larger 
bill, the Paul Wellstone Mental Health and Addiction Equity Act of 
2007.
  Mr. TIM MURPHY of Pennsylvania. Madam Speaker, I am just inquiring 
how much time we have remaining.
  The SPEAKER pro tempore. The gentleman from Pennsylvania has 9\1/2\ 
minutes, and the gentleman from New Jersey has 10\1/2\ minutes.
  Mr. TIM MURPHY of Pennsylvania. Madam Speaker, I yield myself as much 
time as I may consume.
  Madam Speaker, one of the important points that we need to recognize 
as we address these issues of mental health and mental illness today 
are the causes. For so often, as I described earlier, when people are 
thinking about or talking about mental illness, we oftentimes do not 
understand that it really is a problem of brain functioning. It's 
written off too often as the worried well of people complaining or 
malingering, when really we need to understand the following.
  When we're talking about problems with heart disease, it's easy to 
look upon those problems, to look at X-rays and other tests and MRIs 
and see if the function of the heart is appropriate, if the valves are 
working, if the arteries and veins are blocked or free.
  When we look at other illnesses throughout the body, there are so 
many tests which we have grown accustomed to, MRIs, CT scans, EKGs, et 
cetera. And we look at those things and we're able to see that 
something is wrong based upon the results of those tests.
  One of the problems with mental illness, leading to the prejudices 
about mental illness, is that there are no tests like that. One cannot 
take an X-ray of the brain and say that the person has depression or 
anxiety disorder or bipolar illness. There have been multiple studies 
looking at patterns that may show up on some tests. But my point is 
this: Just because we cannot see it on a medical test like that does 
not mean it does not exist.
  Back in the 1800s, Louis Pasteur described the microbes that finally 
led us to understand about germs and diseases. Before that, no one had 
any tests to look at that. It did not mean they didn't exist. That 
merely meant that we did not know that they were there. But it was a 
full century later before we found that one could treat diseases with 
antibiotics, and we're still learning more about it.
  So, too, it is important we understand that so often when discussing 
these issues of mental illness treatment, people raise the question 
that you cannot really test for it. Now, those are areas that science 
and research are still needed to determine what we can do, but it does 
not mean they don't exist just because we cannot find those.
  Instead, what we rely on is the comments made by persons themselves 
or watching the behavior of persons because, indeed, those are the 
indicators that tell us something is wrong with the function of the 
human brain. It is a neurological problem. It is a neurobehavioral 
exhibition of those problems. It is those problems that we have to 
understand that sometimes are treated with medication and sometimes are 
treated with counseling and sometimes both, but we have to make sure we 
understand that we cannot write these off with treatments just by 
ignoring them or just saying that someone else without treatment 
because an insurance plan will cover that is enough.

                              {time}  1645

  Many times cardiologists will tell us that they recognize when they 
give someone a diagnosis that it's terminal or severe, that many of 
those patients will themselves exhibit symptoms of depression, so they 
automatically write a prescription for an anti-
depressant drug. That's not enough.
  The comments I made before about how, when a person has a chronic 
illness, their health care costs can double if they have untreated 
depression, that alone should wake us up to understand that we need to 
be treating mental illness, not ignoring it. That alone should wake up 
employers to understand that improved productivity and lowered health 
care costs should be enough to motivate us to do that. That alone 
should be information that the Congressional Budget Office, who scores 
these bills, should tell us that there are scores that are important in 
terms of savings. Unfortunately, they don't tell us scores for 
prevention. And so it goes on.
  These are things we need to be continuing to do, and that's why we 
will continue to support this bill.
  Madam Speaker, I reserve the balance of my time.
  Mr. PALLONE. Madam Speaker, I yield 3 minutes to the gentlewoman from 
Texas (Ms. Jackson-Lee).
  Ms. JACKSON-LEE of Texas. Madam Speaker, allow me to thank the 
distinguished gentleman from New Jersey for his kindness and his 
leadership, and to add my appreciation as well for Congressman Kennedy 
for the years that he has worked on this issue. And I join them in 
raising our voices.
  I remember the leadership that came from another Member from New 
Jersey, and Congressman Pallone has now embraced this issue in his 
capacity and leadership on the Energy and Commerce Committee. And my 
classmate, Congressman Kennedy, has been pressing this message along 
with Congressman Ramstad for a very long time, that we have the 
capacity and the empathy and sympathy to address the question of mental 
health parity, but

[[Page 1486]]

we have not yet had the energy and the results-oriented efforts that it 
needs.
  I pay tribute, of course, to the late Senator Paul Wellstone, who 
came to my district some years ago through my invitation as cochair of 
the Congressional Children's Caucus and visited our juvenile detention 
centers and emphasized that many of the juveniles that were then 
incarcerated also needed greater access to mental health facilities and 
mental health services.
  Mental health parity and the extension thereof of the annual lifetime 
limits is crucial to save lives. How many of us have seen on the news 
or addressed our constituents where seniors, parents are calling the 
police for their adult children who are suffering from mental health 
needs? Tragically, some of those encounters end in death. There is no 
need for that.
  In addition, we will be seeing, as the war in Iraq ends and 
Afghanistan's war and conflict ends, numbers of individuals coming back 
who have been diagnosed with post-traumatic stress, and we will say 
that's the Veterans Affairs' concern, or brain trauma. Yes, in the 
realm of the framework of their return, it may be; but they will live, 
and through their lifetime may have encounters that need to have the 
coverage of a mental health parity bill.
  I support H.R. 4848 and thank Congressman Pallone for the insight to 
move forward on this extension. But I pray tell that we will find it in 
our determination to move forward on the Paul Wellstone parity bill 
that is being carried by Congressman Kennedy and a number of others. I 
have supported this legislation for a number of years, so I rise 
enthusiastically for H.R. 4848.
  And, if I might, having missed the discussion on H. Con. Res 283, the 
bill dealing with Kenya, I simply want to add my statement into the 
Record, but call out for the compliance with this legislation, as it is 
passed, that we have sanctions for those who will not come to the peace 
table, that we compliment Kenya for its democracy, but, as well, that 
we push them toward a settlement of this vicious incident, having 
killed 900 people.
  I end my comments by asking for enthusiastic support for H.R. 4848.
  Mr. TIM MURPHY of Pennsylvania. Madam Speaker, I yield myself such 
time as I may consume.
  Madam Speaker, many important things have been said by several 
Members, and passionately, on this bill. What we also have to remember, 
as we wrap this up, is somewhere in America there are people who are 
suffering in silence, there are children who are facing abuse, angry 
spouses who are attacking one another, anxious mothers struggling to 
care for their children, and, of course, throughout the workplace, as 
has been so carefully documented here, so many problems. It is 
important that we not only pass this bill strongly but also continue to 
work together.
  I commend my colleague, Chairman Pallone, and the work that he does 
and to continue the work that he does in leading this. Myself and many 
Members from our side of the aisle continue to stand ready to make sure 
we work out any issues with regard to expanding issues of mental health 
parity. We know that all of us care deeply about those in need and all 
of us remain committed to helping those in need from our side of the 
aisle.
  Mr. DINGELL. Madam Speaker, today we are voting to extend for 1 year, 
through 2008, the 1996 Mental Health Parity Act. This act bars the use 
of arbitrary annual and lifetime caps on mental health services if they 
are not also used on other medical benefits. We need to extend this 
first good step taken by Congress more than a decade ago, but there is 
still work to be done to reach true parity in the treatment of mental 
illnesses and substance abuse disorders.
  When the Mental Health Parity Act of 1996 passed Congress, it 
provided only partial parity for mental illness and excluded addiction 
benefits from the equitable treatment other mental health services 
received under the bill. Left untouched were other important and 
potentially costly parts of an insurance policy such as limits on 
inpatient days and outpatient visits and other out-of-pocket expenses 
such as copays, coinsurance, and deductibles. These limits result in 
denying millions of Americans needed treatment and/or incurring huge 
out-of-pocket costs.
  The U.S. Government Accountability Office found in a May 2000 report 
that 87 percent of employers complying with the act merely substituted 
other restrictive limits on things already mentioned for the annual and 
lifetime limits prohibited under the 1996 act.
  Today we must not only extend the Mental Health Parity Act of 1996 
but also continue to work on building this act to achieve true parity 
by passing H.R. 1424, the Paul Wellstone Mental Health and Addiction 
Equity Act of 2007. The legisiation has been favorably approved by all 
three committees of jurisdiction in the House.
  Mental illness and alcohol and drug addiction are painful and private 
struggles with staggering public costs, not to mention the toll these 
conditions take on families and communities. Representatives Kennedy 
and Ramstad have been faithful champions of the Mental Health Parity 
Act of 1996 and speak courageously of their own triumphs.
  I urge my colleagues to vote to extend the authorization of the 
current protections already in place and to continue to work for more 
comprehensive parity.
  Mr. GENE GREEN of Texas. Madam Speaker, I rise today in support of 
H.R. 4848. This legislation is an extension of the Mental Health Parity 
Act of 1996.
  This bill requires that annual and lifetime dollar limits for mental 
health treatment under group health plans offering mental health 
coverage be no less than that for physical illnesses.
  Mental disorders are the leading cause of disability in the U.S. for 
individuals between the ages of 15-44. In fact, 54 million Americans 
currently suffer from mental illness.
  Unfortunately, the stigma of mental illness prevents millions of 
Americans from receiving the health care they need. Arbitrary limits on 
insurance benefits also serve as a significant barrier to many 
Americans seeking help.
  The original Mental Health Parity Act of 1996 was an important first 
step toward mental health parity and mandated that annual and lifetime 
limits in mental health coverage be equal to those applied to medical 
and surgical benefits.
  While I support this bill, I strongly believe that we must pass H.R. 
1424, the Paul Wellstone Mental Health Parity and Addiction Equity Act 
of 2007.
  The scientific community has long told us that mental illness and 
substance abuse are biologically-based, and the Surgeon General 
recognized that fact in the 1999 Surgeon General's report.
  The sad reality, however, is that the health insurance market still 
does not provide true parity to mental health and substance abuse 
coverage.
  Individuals who struggle with mental illness or substance abuse have 
no guarantee they'll get the treatment they need--even if they have 
health insurance.
  Mental illness and substance abuse are serious issues for many 
Americans who too often do not receive the appropriate treatment. 
Twenty-six million Americans struggle with substance abuse addictions.
  I hope that we will recognize the struggles that individuals with 
substance abuse addictions face in seeking treatment.
  I strongly support H.R. 4848 and hope that we will build on this 
piece of legislation by considering H.R. 1424, the Paul Wellstone 
Mental Health Parity and Addiction Equity Act of 2007 sometime this 
session.
  Mr. CONYERS. Madam Speaker, I rise to voice my support for H.R. 4848, 
the extension of the Mental Health Parity Act of 1996 (MHPA). This 
legislation would extend MHPA for 1 year, maintaining the current 
provisions for parity in the application of certain limits to mental 
health benefits.
  For group plans that choose to offer mental health benefits, the MHPA 
requires those plans to provide benefits for mental health treatment 
subject to the same annual and lifetime dollar limits as their coverage 
of physical illnesses. Unfortunately, insurance plans may still limit 
the amount and type of mental health treatment covered. For example, an 
insurance company can cap the number of times a patient may visit the 
doctor's office, not only annually, but over the course of a lifetime.
  ``Partial parity'' is an oxymoron. Rather than rely on stop-gap 
measures and patch-work fixes, the need for true mental health 
insurance parity must be recognized and acted upon. I strongly 
encourage my fellow members to quickly pass H.R. 1424, the Paul 
Wellstone Mental Health and Addiction Equity Act of 2007, which puts 
mental health coverage on an equal footing with medical and surgical 
coverage.
  The inequity of coverage with regard to mental health and substance 
abuse treatment benefits is tantamount to discrimination against the 
mentally ill. It is built upon the insurance companies' strategy of 
denying rather than providing care in order to maximize profits. The 
notion that an insurance company can

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limit medical care based on cost is immoral. Only medical professionals 
should dictate the amount and type of care a patient receives. H.R. 
676, the United States National Health Insurance Act, would provide 
health care coverage for all, including coverage of mental health and 
substance abuse treatment.
  Madam Speaker, it is our duty to end this intolerable discrimination 
against the mentally ill, and provide timely, appropriate, and adequate 
health care for all, free of the loopholes, pitfalls, and entanglements 
which exist under the current fragmented, non-system of care.
  Mr. RODRIGUEZ. Madam Speaker, today I stand in support of H.R. 4848, 
extension for 1 year, parity in the application of certain limits to 
mental health benefits.
  H.R. 4848 would amend the Employee Retirement Income Security Act of 
1974 (ERISA), and the Public Health Service Act to extend until 
December 31, 2008, mental health parity provisions, which require group 
health plans to treat equally mental health benefits and medical and 
surgical benefits for purposes of lifetime limits or annual limits on 
benefits covered by the plan.
  Approximately two-thirds of individuals with potentially diagnosable 
disorders do not seek treatment. A majority of insured and uninsured 
individuals suffering from untreated mental health disorders mention 
cost as the primary reason that they do not use or seek mental health 
treatment. This is due in part to unequal health insurance coverage for 
mental health services, which results in significant cost-shifting from 
private insure to individuals.
  As a former social worker, I personally know untreated mental illness 
is associated with a number of societal problems. Such as, higher rates 
of unemployment, crime and increased welfare cost.
  Parity for mental health is needed because, left on their own very 
few employers would offer mental health benefits at a level that is 
equal to medical and surgical benefits in their group health plan.
  Mental health is a serious issue facing many Americans. The goal of 
H.R. 4848 is to make sure everyone gets effective quality treatment for 
mental illness. In order for that to happen, mental illness needs to be 
treated just like other surgical and medical treatments.
  Mr. TIM MURPHY of Pennsylvania. Madam Speaker, I yield back the 
balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New Jersey (Mr. Pallone) that the House suspend the 
rules and pass the bill, H.R. 4848, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. BROUN of Georgia. Madam Speaker, on that I demand the yeas and 
nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

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