|
Vermont fears
pre-emption from Senate bill
(August/September
2007 Issue)
By Phyllis Hanlon
A mental health parity bill introduced by Senators Edward Kennedy
(D-Mass.) and Peter Domenici (R-N.M.) promises to enhance the 1996
federal parity bill. However, Vermont, which has the country's most
extensive, comprehensive mental health parity bill on the books,
fears that some of its critical provisions will be pre-empted should
the Senate bill (S.558) become law.
According to Ken Libertoff, executive director of the Vermont Association
for Mental Health (VAMH), S.558 features "two profound shortcomings."
He notes that the legislation may increase coverage, but bears "little
relationship to parity." He emphasizes that Vermont's parity bill
mandates participation, while the Senate bill fails to include this
language. "What will be the outcome if insurers decide not to cover
mental health diagnoses?" Libertoff asks. "Lack of mandation is
a potential loophole that could have negative consequences."
Troubled by the vagueness in how coverage will be designed, Libertoff
worries that the business community and insurers will develop their
own benefits packages to the detriment of the consumer.
Additionally, he and others in the state express concern that the
federal bill will override the parity bill passed in Vermont as
well as those in other states. Libertoff says, "There has been an
inability to clarify pre-emption and consumer protection that goes
over and above what states have achieved."
During the last five to 10 years, concern has grown around the
country as the federal government attempts to pre-empt state laws,
particularly those relating to healthcare, says Libertoff.
Libertoff says that the more than 105 agencies and organizations
that support S.558 have honorable, but misguided, objectives. "The
intention of those who have signed on is good, but doesn't lead
to useful, effective and meaningful legislation," he says. "Until
we have universal health care, the states will carve out what they
can. The federal bill intervenes into states' rights."
The American Psychological Association's Executive Director for
Professional Practice Russ Newman, Ph.D., J.D., reports that the
APA has conducted a "pretty extensive legal analysis" of the Senate
bill and believes that it will not pre-empt mental health parity
or other laws in the states. "[This bill] would take the comprehensive
provisions of the Senate law and put them into states where they
currently have no mental health parity," he says. "Vermont mandation
would continue."
Newman points out that the states laid the groundwork for the federal
bill by passing interim protection until the federal bill could
be expanded. Congress is now adopting the models already created
by the states, he says. "Enactment will enable the 80-plus million
people who are not covered by any state law now to have coverage,"
says Newman.
Although the federal bill is comparable for the most part, Newman
notes that it will impose financial and treatment limits and will
be "conditional," rather than mandatory like the Vermont bill.
Representatives Patrick Kennedy (D-R.I.) and Jim Ramstad (R-Minn.)
have sponsored a parity bill in the House (H.1424) that has earned
kudos from mental health professionals as it includes a provision
not to pre-empt more stringent state laws.
|
