In a quirky procedural twist, the long-sought bill to require mental health insurance coverage in parity with somatic conditions has become intertwined with the contentious legislation to help rescue the nation's financial system.
Essentially, if the financial bailout gets through Congress, so does the bipartisan parity bill. If the financial aid bill fails, Congress will have to figure out another way to make the parity requirement law -- as well as find a way to save the nation's economy.
The Senate took the first step toward parity last night when it passed the financial rescue package 74-25, with presidential candidates Sens. John McCain and Barack Obama voting in favor of the legislation.
"There is renewed hope for millions of Americans facing mental illness," said Sen. Edward Kennedy (D-Mass.), a longtime champion of mental health parity, in a release from his home in Massachusetts.
"The bill now goes to the House of Representatives, and I urge them to act now to end discrimination and prejudice. Millions of Americans are waiting -- and they've waited too long already."
The marriage of the two bills springs in part from the rule that all spending bills must originate from the House. So last night, negotiators picked an earlier mental health parity bill as the container for the financial package.
The House easily passed that mental health parity bill in March. But it was dead on arrival in the Senate because of language that would have required insurance companies to give equal coverage to all mental illnesses outlined in the DSM.
This was a far-reaching stipulation that made some conservatives squeamish, according to Peter Newbould, director of congressional and political affairs for the American Psychological Association's Practice Organization.
Last week, the House passed a standalone mental health parity bill and then the Senate rolled its version into the tax break extenders bill before voting to approve it. (See: True Coverage Parity for Mental Health Services Close to Reality)
Now comes the tricky part. The mental health parity language from that March bill will be entirely stripped out by the Senate. Into the empty shell will go the financial rescue plan, and the tax break extenders bill that includes mental health parity legislation passed by the Senate last week. This removes any mention of the DSM.
Instead of the two chambers going to conference to work out the differences between the two versions of the parity bill, the legislation, if the entire package is passed, can go straight to the president for approval.
So the parity bill is hostage to the financial aid bill, with everything now riding on House approval.
"By this rather dramatic move last night of the negotiators marrying the several issues left in the Congress to deal with, we're going to win," said Newbould. "We're going to be part of this Wall Street mainstream rescue package that includes the tax extenders and it's a welcome development."
"I have no doubt that we're going to ride into the Rose Garden on this bill," said Newbould.
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If you want to see for yourself, you can go to page 310 of the actual bill.
If you can see past the smoke and mirrors (because I certainly can't), feel free to disagree with me about the "parity" of this "mental health parity" rider.
And that's also a good example of why we need universal health care. Because someday I am likely to run into points at which I cannot afford the $120 a month that my one medication costs and that my current insurance doesn't even cover. But oh no, if the government somehow takes on that expense, it'll drain the economy dry. Unlike unmedicated me losing my job and having to apply for unemployment, which would be paid for by magical money trees.
In conclusion, fuck health care.
And I'm well aware that my disease could be easily taken care of if I just got a few pep talks and ~*~smiled more~*~.Edited at 2008-10-03 12:12 am (UTC)
I have a lot of friends who have trouble getting that one covered.
has your doctor called the insurance company to argue with them? that can do wonders. sometimes doctors are just too lazy to inform you of this and most pharmacies are just too indifferent to tell you that your doctor can make a phone call and sometimes that's all it takes to override insurance companies telling you they "won't cover it."
SO MANY TIMES I have gone to CVS to hear: "sorry, insurance won't cover it. that'll be $375." one phone call to my doctor, who makes a phone call to my insurance and argues the case, and presto! all's good.
even when I had to switch insurance companies - to the fucking one I have NOW that will not cover ANY psychotherapy out-of-network even though I've been seeing my psychiatrist (also my therapist) for 5 years now and already owe her $9000 since I've been on a payment plan for 3 out of the 5 years [when my dad stopped paying for therapy; that number has gone up SIGNIFICANTLY since my insurance changed], this was true.
the list of shit I've gotten approved after she made one phone call is absurd. 30 tabs of ambien + 30 tabs of ambien cr per month (after being told "they're the same medication."). 180 tabs of dexedrine + 60 tabs of adderall xr per month (after being told "they're the same medication," "the doses are too high," and "adderall xr is a once daily medication.") 360 tabs of parnate per month (double the max fda dosage; I was taking 120 mg/day and they only came in 10 mg tablets). brand-name parnate even when it became generic. brand-name zoloft even though generic has been available for years (only on my last insurance; this insurance company required a "medical reason" and - aside from "um, it worked better" - there is none).
out of curiosity, why do you even have insurance if you're still paying out of pocket for one medication? doctor's visits? "just in case" something happens?
She's actually switching jobs right now because the health insurance at her current job is so bad. It's fucking ridiculous that middle class people have to resort to that shit in this country just to provide basic health care for their families.
the chewable kind is DEFINITELY available.
I know that there's a huge disparity between generics and brand from personal experience and that this is dangerous for someone with BP disorder. but maybe you could try it one month?
it's actually recommended by the FDA that epileptics do NOT take generic anticonvulsants because of how different they can be from brand name. of course, the FDA doesn't give a fuck about psychiatric illness and so these recommendations are not replicated for bipolar patients.