Lawmakers Urged to Include Parity in Healthcare Reform

A new poll finds strong public support for including addiction coverage in national healthcare reform, and advocates are calling on the chairman of the Senate Finance Committee to incorporate the core provisions of the Wellstone addiction and mental health parity legislation into health reform legislation so that they apply to all health plans in the U.S.

More than three-quarters of Americans polled by the group Closing the Addiction Treatment Gap (CATG) support inclusion of addiction treatment in healthcare reform, including 72 percent of Republicans, 86 percent of Democrats, and 72 percent of independent voters.

The poll also found that 70 percent of those polled said they would be willing to pay out of their own pocket for greater addiction treatment coverage. Strong majorities stated that they would pay an extra $2 per month in premiums for improved treatment access; treatment advocates estimate that parity would cost policyholders less than $2 per month. “The poll documents strong bipartisan public support for addiction as a health issue, and therefore including addiction in all aspects of health reform,” said CATG director Victor Capoccia, Ph.D.

Only about one in 10 Americans who need addiction treatment get services, with cost and access issues topping the list of barriers to treatment, according to researchers.

“In the context of current reform, we urge policymakers to take action to address and support this major public health problem of addiction,” said Richard Carmona, M.D., former U.S. Surgeon General and a professor at the Zuckerman College of Public Health at the University of Arizona. “We would not allow nine of 10 people to remain untreated with any other disease. Including addiction is not only the right thing to do, but it makes financial and social sense as well.”

Baucus Bill Targeted

In a Sept. 14 letter to Senate Finance Committee Chairman Max Baucus (D-Mont.) — who has taken the lead on drafting the leading Congressional healthcare reform bill — the American Bar Association (ABA) urged lawmakers to include the parity provisions from the Paul Wellstone and Pete Domenici Mental Health and Addiction Equity Act of 2008 in its proposed healthcare reform legislation.

ABA government affairs director Thomas Susman noted in his letter that the 2008 parity legislation was applicable only to some employer-sponsored health plans, whereas, “To ensure that the millions of Americans suffering from addiction are provided equitable coverage, the ’parity’ provisions should be made applicable to all plans covered by the new health care legislation.”

Sen. Debbie Stabenow (D-Mich.) reportedly has agreed to sponsor an amendment that would insert the Wellstone parity language in the Baucus bill, which is generally seen as having weaker protections in place for addiction and mental health coverage than the main healthcare-reform bill in the House of Representatives. In addition to lacking the parity language, the Baucus bill also does not mandate that large employers must cover addiction and mental health.

“The lives of 23 million people who are addicted to alcohol and drugs depend in part on addiction as a health condition [being] covered as a core service … in every health reform bill in both houses of Congress,” said CATG’s Capoccia.

In fact, all mandated-benefits language was deleted from the Baucus bill in order to win support from the business community, not just that applying to behavioral healthcare. In a statement on the Baucus bill, addiction-treatment advocate Rep. Patrick Kennedy (D-RI)  said that “meaningful health care reform must not only ensure access to mental-health and substance-use care, but must also ensure that those who seek these services will not be subject to discrimination when seeking care.”

Kennedy expressed disappointment that the Baucus proposal “does not move farther in ensuring those protections,” but field sources told Join Together that they are optimistic that the Stabenow amendment would be approved by the Senate Finance Committee.

Kennedy also is currently circulating a sign-on letter to fellow lawmakers that urges the Department of Health and Human Services, Labor and Treasury to draft parity regulations as soon as possible; the legislation says the regulations should be issued by Oct. 3.

Advocates are concerned about the potential for confusion and misinterpretation if the Wellstone law goes into effect on Jan. 1 without regulations in place. Also, as Kennedy noted in his letter, “Any large-scale changes to our national health care system should have a clear benchmark of strong mental-health parity regulations to which we can refer in order to avoid future barriers to live-saving care.”