Georgetown University National Technical Assistance Center for Children’s Mental Health TA Conference Call Series The Paul Wellstone and Pete Domenici Mental Health Parity & Addiction Equity Act Presentation by Andrew Sperling Director of Legislative Advocacy NAMI National February 19, 2009

First, A Little History … May 1992 – first federal bill introduced – S & 1994 – Clinton Health Care Reform, standard minimum federal benefit with discriminatory limits April 18, 1996 – Amendment to HIPAA legislation passes Senate September 22, 1996 – Domenici-Wellstone Amendment signed in to law as part of FY 1997 VA-HUD Appropriations bill, parity for annual and lifetime dollar limits only 1996 – parity enacted in only 6 states (MD, MN, NH, RI, NC & TX state employees; by 2000, more than 25 states have enacted parity, including AL, CA, IN, NJ, SC & TX June 1997 – Parity requirement added to Senate SCHIP bill, then dropped in House-Senate conference

Efforts in Congress Continue … June 9, 1999 – President Clinton signs Executive Order requiring parity for all FEHBP plans – 9.5 million covered lives – becomes model for all future federal parity proposals October 30, 2001 – Senate adopts parity amendment to the FY 2002 Labor-HHS Appropriations bill April 30, 2002 – President Bush endorses parity at the University of New Mexico October 25, 2002 – Senator Wellstone dies in plane crash 2006 – Negotiations commence with employers and health plans, Senator Enzi plays a key role

Efforts in Congress Accelerate … February 14, 2007 – S 558 reported by the Senate HELP Committee September 18, 2007 – Senate passes parity bill (S 558) by unanimous consent after disputed language on state preemption is removed March 6, 2008 – House passes parity (HR 1424) by a vote of – after clearing 3 separate House Committees Late June 2008 – agreement reached by all parties, budget offsets needed October 3, 2008 – Parity attached to financial market recovery legislation and signed in to law

Parity in Group Health Plans P.L , signed on October 3 Attached to the financial market rescue and tax extenders legislation Becomes effective in new group health plan years starting after October 3, 2009 Requires equity in coverage with respect to: –Durational treatment limits (caps on inpatient days and outpatient visits) –Financial limitations (higher cost sharing, deductibles, out-of-pocket limits)

Questions?