MEDIA ADVISORY, Wednesday, September 26, 2007
CONTACT: Yoni Cohen, Stark (202) 225-3202

WASHINGTON, D.C. -- Representative Pete Stark (D-CA), Chairman of the Ways and Means Health Subcommittee, delivered the following opening remarks at today's Ways and Means Committee mark up of the Paul Wellstone Mental Health and Addiction Equity Act (H.R. 1424).

"I thank the Chairman for taking action on this important legislation. The changes made by HR 1424 are long overdue.

The mental health parity law we passed in 1995, while an important step forward, leaves far too much room for abuse. As a result, patients with mental health and addiction disorders have not been able to get the treatment they need. The bill before us today closes these loopholes by extending existing parity requirements to substance abuse treatment. It also ends the discriminatory practice of charging higher co-payments and deductibles or imposing limits on treatment for mental health and substance abuse services -- unless similar limitations or requirements are imposed for medical or surgical benefits.

Much has been made of the minimum scope of benefits requirement in HR 1424. This requirement is necessary because, for years, mental and addictive disorders have been systematically and unfairly excluded from equal coverage by health insurers. The same is not true of medical or surgical exclusions which typically apply to certain treatments or procedures (such as cosmetic surgery), not for a whole class of diagnoses (such as eating disorders). By establishing the Diagnostic and Statistical Manual (“DSM-4”) as the minimum benefit standard, HR 1424 corrects this historic discrimination.

Opponents of HR 1424 have also raised a concern that plans would not be able to continue “managing” mental health benefits. Let me assure my colleagues that plans can “manage” medical, surgical, and mental health and substance abuse benefits today through medical necessity determinations and other procedural means, and they would be able to continue managing benefits under the requirements of HR 1424. The requirement that plans make their criteria for medical necessity determinations available to plan enrollees included in this bill should make this eminently clear.

Finally, with all due respect to my colleagues in the Senate, only HR 1424 achieves equity between medical/surgical and mental health benefits. The Senate bill does not require plans to cover out-of-network services for mental health and substance abuse, even if the plan covers out-of-network services for medical and surgical benefits. This enables plans to continue to discriminate against patients with mental and addictive disorders. The House bill, on the other hand, requires plans that cover out-of-network services for medical and surgical benefits to cover out-of-network services for mental health and substance abuse. This is true parity!

HR 1424 is the legacy of the late Senator Paul Wellstone of Minnesota – a true champion for all people, and especially those who suffer from mental illness and addiction. It is also a tribute to the dedication of our colleague Jim Ramstad, who I admire greatly.

It has broad-based bipartisan support with 270 cosponsors in the House and is endorsed by hundreds of organizations representing patients, families, and mental health and addiction treatment providers.

Thank you, Mr. Chairman for bringing this important legislation before us today. I look forward to its speedy passage."