Plan to Expand Mental Health Coverage Likely to Fail

Congressional negotiators today are expected to kill a measure to expand health insurance coverage for mental illness, despite bipartisan support for the proposal.

Proponents of the measure, which would prohibit group health plans from imposing tighter restrictions on mental health benefits than on other medical ailments, say they expect to lose a key vote in a House-Senate conference committee.

“It doesn’t look very good,” said Jim Farrell, spokesman for Sen. Paul Wellstone (D-Minn.).

The measure, spearheaded by Wellstone and Sen. Pete V. Domenici (R-N.M.), would expand a 1996 law that established the principal of mental health “parity.” The law prohibited private insurance companies from setting limits on mental health benefits unless those limits also applied to other illnesses.

Insurance companies, citing financial needs, found other ways to curb benefits for the mentally ill, such as limiting the number of covered visits each year.

In response, Domenici and Wellstone this year pushed for a broader proposal that would require parity not just in overall benefits but in terms of what costs are covered and the access provided to services.

Business groups and insurance companies vigorously opposed the measure, saying it would drive up the cost of providing health insurance just as the economy has been worsening.

The Senate approved the Domenici-Wellstone measure as an amendment to the annual appropriations bill for the Health and Human Services Department and Education and Labor departments. But it was not included in the House version of the spending bill, and House GOP leaders have opposed the mental health provision.

The issue will come to a head today at a meeting of the conference committee writing the final version of the appropriations bill.

House conferees are expected to vote on whether to accept the Senate amendment, and the Republican majority among them is expected to unite and vote to reject it.

“We have not heard of any defections,” said John Scofield, spokesman for Republicans on the House Appropriations Committee.

Scofield acknowledged that face-off will require some Republicans who have supported the mental health measure in the past to vote against it. “It’s a tough vote for some of our members,” said Scofield. The Bush administration has said it did not want to address the issue this year.

Scott McClellan, a White House spokesman, said Monday that President Bush remains “committed to this important priority” and told Domenici in a letter that he “looks forward” to working with Congress on it next year.

The 1996 law officially expired Sept. 30. One option being considered is for Congress to pass a short-term extension of the measure in the closing days of this session. But Wellstone opposes that move because, Farrell said, the 1996 law has been rendered toothless.

Resolution of the mental health dispute will clear the way for congressional approval of the broader $135-billion appropriations bill, which includes funding for the president’s education initiative.

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Times staff writer Edwin Chen contributed to this report.