The “Paul Wellstone Mental Health and Addiction Equity Act of 2007”

On March 5th, the full U.S. House of Representatives voted to approve H.R. 1424, the “Paul Wellstone Mental Health and Addiction Equity Act of 2007” by a 268 to 148 vote.  221 Democrats and 47 Republicans voted for passage of the bill.  H.R. 1424 would require group health plans that currently offer coverage for drug and alcohol addiction and mental illness to provide those benefits in the same way as benefits provided to all other medical and surgical procedures covered by the plan.  Last fall, the House Education and Labor, Ways and Means, and Energy and Commerce Committees each voted to approve this legislation.  H.R. 1424, which has 274 bi-partisan co-sponsors, was introduced on March 6, 2007 by Congressmen Patrick Kennedy (D-RI) and Jim Ramstad (R-MN).

The vote for passage of H.R. 1424 followed two hours of debate on the House floor about the legislation, with a number of Members expressing strong support or opposition to the bill.  At the conclusion of this debate, Congressman John Kline (R-MN) offered a motion to substitute the Senate parity bill, S. 558, in the place of H.R. 1424.  This attempt failed, however, by a 196 to 221 vote, with 209 Democrats and 12 Republicans voting against the substitution.  S. 558 was approved by the full Senate in September 2007.

There are a number of significant differences between H.R. 1424 and S. 558.  Provisions included in H.R. 1424 but not in S. 558 are: 

• Explicit protection of State laws that provide greater protection than the federal law 

• Out-of-network coverage for substance use disorders and mental illness where there is out-of-network coverage for medical and surgical conditions 

• Coverage for conditions and disorders in the Diagnostic Statistical Manuel of Mental Disorders (DSM-IV) 

• A requirement that medical necessity criteria and reasons for any denials of reimbursement be available to participants and beneficiaries upon request 

Now that the House and Senate have each approved their respective bills, there will likely be negotiations to resolve the differences between H.R. 1424 and S. 558.  It is unclear whether there will be a structured conference process or whether negotiations will occur more informally. 

Written transcripts of the House floor debate on H.R. 1424 can be found in the Congressional Record at: http://thomas.loc.gov/home/r110query.html. 

The record of the vote for final passage of H.R. 1424, Roll Call Vote # 101, can be found at: http://clerk.house.gov/evs/2008/index.asp. 

For further information, please contact: Gabrielle de la Gueronniere, Deputy Director for National Policy, at gdelagueronniere@lac-dc.org or Nisha Thakker, Policy Associate, at nthakker@lac.org.

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