To nail down its final approval, the $700 billion bailout had to be strapped onto a measure that requires equality between mental health and other medical benefits in health care plans that offer both.
When Congress returns to Washington in January, legislators likely will make the faltering economy the top priority, but health care reform will remain in the mix.
Perhaps the first piece of the puzzle was put on the table October 7 by a bipartisan group of prominent senators in health care policy, including Sens. Max Baucus, D-Montana; Charles Grassley, R-Iowa; Mike Enzi, R-Wyoming; and Ron Wyden, D-Oregon.
They introduced a “discussion draft” of legislation that would require companies to disclose on employees’ W-2 tax forms the amount of money they spend annually on health insurance. The idea emanated from a set of hearings designed to prepare Congress to legislate next year on health care.
The bill is designed to enlighten workers regarding how much money their employers spend on health care and its effect on wages. The senators are collecting public comment until December 31.
The initial reaction from the business community is mixed. Diann Howland, vice president for legislative affairs at the American Benefits Council in Washington, says that most members of the organization, which includes more than 200 large employers, already provide annual benefits statements to employees.
She’s concerned that the bill would foist an administrative burden on companies and subject them to liability regarding the tax form. She adds that employers want to increase benefits transparency.
“We share a lot of the same goals,” Howland says of the bill. “It’s a matter of how you get there.”
Kathleen Lester, a partner at the law firm Patton Boggs in Washington, says few of her clients have reacted to the bill. But the senators have the right motivation.
“It’s important for consumers to know what things cost and how it drives treatment options and quality [of care],” Lester says.
Seeking wide input on the part of Capitol Hill was a hallmark of the parity bill. Businesses, insurers and mental health advocates hammered out a compromise over three years that resulted in strong bipartisan backing.
The bill does not mandate mental health coverage. But if it is offered, it must be equal to other medical and surgical benefits in deductibles, co-payments, out-of-pocket expenses, coinsurance, covered hospital days and covered outpatient visits.
The parity negotiation process is a model for larger reforms, Howland says.
“Although it’s painful, it’s a better way to proceed,” she says. “In the end, you’ll get a product that people say, ‘We can support this.’ ”
Among the candidates for the first health measures of 2009 are a bill to establish nationwide standards for the adoption of health information technology, which stalled this year because of privacy concerns and the cost transparency measure.
“We will probably see folks take small steps like that,” Lester says.
—Mark Schoeff Jr.
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