A Great Day for Mental Health Coverage

On October 3, 2008, as the nation collectively held its breath over the passage of the $700 billion Emergency Economic Stabilization Act, a little-known piece of legislation with a huge impact on the future of mental health care was signed into law. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 requires that, for the first time in history, health plans (for companies with 50 or more employees) approach coverage for mental illnesses and substance abuse as they do physical diseases. In other words, the person who for decades has faced higher co-pays or deductibles for treatment of depression or alcoholism—as well as stricter limits on inpatient and outpatient visits—will now get benefits equivalent to someone in their plan receiving care for, say, heart disease. When the new law goes into effect on January 1, 2010, more than one-third of all Americans—about 113 million people—will see a boost in their coverage.

The bipartisan bill is named for senators Paul Wellstone, the Minnesota Democrat who was killed with his wife and daughter in a plane crash in 2002, and Pete Domenici, a Republican from New Mexico (who retired at the end of last year). Each had personal reasons for proposing the law: Wellstone witnessed a brother's institutionalization for mental illness and the financial burden it put on his family, while Domenici's daughter suffers from a form of schizophrenia. "Our healthcare system has acted as if the mentally ill weren't sick and so were not entitled to the same kind of care as other sick people," says Domenici. "We created a second tier of citizens. It's an inequity that should have been resolved years ago, but we're thrilled that it's resolved now."

The law does have limitations, notes Andrew Sperling, director of federal legislative advocacy for the National Alliance on Mental Illness: The millions of people working for businesses with fewer than 50 employees won't see a benefit; nor will the self-employed who buy coverage individually or through a guild or association (unless their plans comply with the new law on their own). Nevertheless, "this is a true parity for those affected by the law," says David Wellstone, the senator's son, a social activist who lobbied vigorously for the new law. "I know my father would be happy with this bill. Still, all plans should offer coverage. We have to do more."