White House May Dilute Mental Health Benefit Rules

By Robert Pear N. Y. Times News Service | THE JOURNAL RECORD, October 22, 1997 | Go to article overview
Save to active project

White House May Dilute Mental Health Benefit Rules


Robert Pear N. Y. Times News Service, THE JOURNAL RECORD


WASHINGTON -- New rules being drafted by the Clinton administration could allow many employers to exempt themselves from a landmark law intended to expand health insurance benefits for millions of Americans with mental illnesses, federal officials and mental health advocates said.

When President Clinton signed the bill, the Mental Health Parity Act, on Sept. 26, 1996, he said it was "morally right" to "require insurance companies to set the same annual and lifetime coverage limits for mental illness" and physical illness.

"No more double standards," he said then. But 10 weeks before the law takes effect, the administration has become embroiled in a bitter dispute over how to enforce it. The White House is trying to satisfy both mental health advocates and employer groups, and that may be impossible. At the moment, the mental health groups are unhappy and are trying to persuade the administration to limit use of the exemption. The law, passed last year with Clinton's support, seeks to curb discrimination in insurance. It says that group health plans may not impose lower limits on mental health benefits than on medical and surgical benefits for treating cancer, heart disease and other physical illnesses. Such disparities are extremely common. A typical employer- sponsored health plan may have a lifetime limit of $1 million on regular medical benefits, but $50,000 on mental health benefits. The law allows an exemption if the new mental health benefits increase the cost of a group health plan or coverage by 1 percent or more. But the law does not define cost, nor does it specify how the exemption process will work. Administration officials said they hoped that most employers would find it easier to comply with the law than to seek exemptions. While administration officials had not made final decisions, they said the new rules would probably allow employers to obtain exemptions by estimating their future costs using 1997 data. Chris Jennings, a White House aide who coordinates health policy for Clinton, said, "We will not set up a new government bureaucracy to review and approve every plan that wants an exemption." Rather, he said, employers can hire actuaries to assess whether their costs will increase at least 1 percent. The administration's approach has infuriated advocates for the mentally ill, psychiatrists, psychologists and some state health officials, who say it will eviscerate the 1996 law. Shelley S. Stewart, deputy director of federal relations at the American Psychiatric Association, said that employers should be required to comply with the law throughout 1998 before being allowed to seek exemptions. "If employers abide by the law," she said, "they will find that it is not as costly as they expect." Sen. Paul Wellstone, a co-author of the 1996 law, said the idea of allowing companies to get exemptions by estimating the costs of compliance was "in direct contradiction to the spirit and letter of the legislation passed last year." In an interview Monday night, Wellstone, a Minnesota Democrat, said: "I know exactly what we intended. This is the law of the land, and companies should live under it. If companies want to come back after a year, and if they can show us empirical evidence that their costs have gone up by X percent, then and only then should they be able to get any kind of exemption. These exemptions should not become a big loophole." But employers, insurers and managed-care companies insist that they should be able to get exemptions based on projections of their 1998 costs.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

White House May Dilute Mental Health Benefit Rules
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?