Mike Lillis of the Washington Independent has a good article on the efforts being made to bring health-insurance coverage for mental illness in line with the coverage for physical illness. As of know, the difference is shameful. His article begins:

For the estimated 60 million Americans suffering from mental illness, treatment can be an elusive and costly ordeal. Many health care plans don’t cover mental care, and those that do usually provide lesser benefits for mental disorders than for physical ailments. Co-payments, for mental patients, are usually higher. In addition, the last major federal law tackling the problem is 12 years old.

Now Congress is hoping to fix some of that. Bills passed in both the House and Senate would require most employer-based health plans to eliminate the current pay discrepancies between coverage for mental and physical conditions. Supporters say that equating the two — and thus establishing “parity” — is long overdue. Helping their push, the stigma that’s contributed to the legal discrimination has slowly faded as scientists uncover the biological and genetic causes of mental disorders.

“There is no shame in mental illness,” House Speaker Nancy Pelosi (D-Cal.) said following passage of the House bill in March. “The great shame would be if Congress had not taken action.”

But much work remains. Significant disparities between the Senate and House bills have forced sponsors into informal but delicate negotiations. The saga has aligned senators of both parties, the White House, business groups and the insurance industry — all of whom support more business-friendly reforms — against House lawmakers pushing for broader patient benefits.

The negotiations could prove a dilemma for House Democrats, who have increasingly shown an eagerness to stand firm on non-compulsory legislation in lieu of caving to the demands of industry and the administration. Led by Pelosi, Democrats in Congress’s lower chamber have confronted the White House head-on over wiretapping legislation and a free trade deal with Columbia, for example — in each case supporting the populist agenda that swept the party into power two years ago. The resulting stalemates seem to indicate that Democrats would be willing to kick these issues to next year, when the party is expected to command larger congressional majorities and, perhaps, control the White House.

Mental health advocates are optimistic the parity reforms will move this year — and they have several things working in their favor. First, the Senate bill has broad bipartisan support, with Sen. Edward M. Kennedy (D-Mass.) a leading force behind it. Also, two long-time champions of parity — Sen. Pete Domenici (R-N.M.) and Rep. Jim Ramstad (R-Minn.) — are retiring at the end of the year, putting pressure on lawmakers in both chambers to honor their work by enacting reforms before they depart. Both lawmakers have personal investments in the the parity push: Domenici’s daughter has schizophrenia, and Ramstad is a recovering alcoholic.

In the eyes of Washington’s power-brokers, their cause hardly constitutes must-pass legislation, but with some momentum behind it, the parity legislation could be a rare instance of an election-year success.

Neither the House nor Senate bill forces insurers to cover mental treatments. But under both proposals, group health plans that opt to cover such care could no longer make the mental benefits more restrictive or costly than those for comparable medical and surgical treatments.

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