If anyone wonders why the government should not decide which benefits health plans must provide, let him observe the troubled birth of the “Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.” Wellstone-Domenici had languished in Congress for a full 16 years and got passed as part of the Wall Street bailout bill chaotically rushed into law earlier this month.

We already have a federal Mental Health Parity Act, passed in 1996. Like the new law, it controls health benefits for groups of at least 50 persons, and does not require health plans to offer benefits at all. However, if a plan does offer mental health benefits, the original law requires only that annual or lifetime dollar limits on those benefits be at least equal to those for medical or surgical benefits. Nor does it apply to substance abuse or chemical dependency. This was not good enough for advocates of a stricter definition of mental health parity, who demanded that treatment limits, co-payments, and deductibles should be exactly the same for mental health benefits as medical and surgical benefits. They also demanded that mental health benefits include treatment for substance abuse.

Read PDF