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California may prove to be the bellwether state for incremental parity. Six years after the first narrowly defined bill was enacted, the state Senate voted 22-8 in June to approve a broader bill mandating parity for seven severe mental illnesses.
At press time, the bill's cosponsor, state Assemblywoman Helen Thomson (D-8th District) told Psychiatric News that she was hopeful that Gov. Pete Wilson (R) would agree to a compromise on the unlimited hospital stay provision, which he staunchly opposes. If that happens, the amended bill will be returned to the Senate and Assembly for final approval.
If the bill becomes law, health insurance and disability insurance plans will have to provide the same level of coverage for "biologically based" mental illnesses for adults and children as physical illnesses including prescriptions and doctors' visits. The law would also apply to serious emotional disturbances for children.
The "biologically based" mental illnesses listed in the bill are schizophrenia, schizoaffective disorder, bipolar disorder, major depression, panic disorder, obsessive-compulsive disorder, and pervasive developmental disorder or autism.
Thomson, who introduced the bill with Assemblyman Don Perata (D-Alameda) in January of last year, said the 1997 RAND report was helpful in persuading legislators that parity is affordable (Psychiatric News, July 7, 1997). The results showed that eliminating the typical average annual dollar limit of $25,000 would increase insurance premiums by only $1 per enrollee per year in a managed care carveout.
Moreover, results of a statewide survey released in June showed that 90 percent of registered voters in California believe health plans should provide the same coverage for mental illnesses as they do for other illnesses.
Thomson noted that a vocal opponent of the bill, the California Chamber of Commerce, might become less critical because of the results of its recent poll. A majority of its small business members supported mental health parity and would be willing to pay up to a 5 percent increase in insurance premiums.
A coalition of mental health groups supported the bill including the California Alliance for the Mentally Ill, California Psychiatric Association, and the California Mental Health Association. The California Medical Association was also supportive.
CPA Government Affairs Director Conni Barker told Psychiatric News that its members engaged in a successful letter-writing campaign to legislators, especially to moderate Republicans, who were considered swing votes.
Legislators with family members or friends with mental illness tend to be the most sympathetic to mental health parity, Barker observed. For example, Sen. Richard Polanco, (D-Los Angeles) who helped push the bill through the Senate, recalled that when he was 10, his mother had a bout with mental illness and there was no support group available.
Moreover, "the legislators who introduced the bill are deeply committed to the issue. Thomson is a psychiatric nurse and Perata has a sister with schizophrenia," Barker noted.
She commended NAMI for its media campaign, which included running an ad in the Sacramento Bee listing the governors that have signed parity bills into law.
"NAMI also provided the lobbyists with glossy images of normal and disordered brains. Being able to show the difference was a very effective tool in persuading legislators that mental illness is biologically based," Barker commented.
For an update on the bill's status (AB 1100) go to CPA's home page at (www.calpsych.org/) and click on Calif. Government/State Senate Site.