IV

103D CONGRESS

1ST SESSION H. CON. RES. 59

Expressing the sense of Congress that any health care reform program enacted by Congress should not discriminate in the treatment of services

relating to mental illness and substance abuse.

IN THE HOUSE OF REPRESENTATIVES

MARCH 4, 1993

Ms. NORTON submitted the following concurrent resolution; which was

referred to the Committee on Energy and Commerce

CONCURRENT RESOLUTION

Expressing the sense of Congress that any health care reform

program enacted by Congress should not discriminate

in the treatment of services relating to mental illness

and substance abuse.

Whereas mental illness and substance abuse disorders are

prevalent throughout our society;

Whereas approximately 19 percent of the adult population in

the United States suffers from a diagnosable mental illness or a substance abuse disorder within any 6-month

period;

Whereas approximately 12 percent of Americans under the

age of 18, or 7,500,000 children and adolescents, suffer

from some type of mental illness or emotional disorder;
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Whereas 4⁄5 of children in need of mental health care do not

receive services, resulting in significant costs to society as

these children become adults;

Whereas approximately 1⁄3 of homeless people suffer from a

mental illness and approximately 40 percent of homeless

people suffer from a substance abuse disorder;

Whereas there are more Americans with a serious mental illness in prisons and street shelters than in hospitals;

Whereas the incidence of mental illness and mental health

problems is very costly both to the individual with a mental disorder and to society as a whole;

Whereas American businesses lose over $100,000,000,000 per

year due to lost productivity of employees because of substance abuse and mental illness;

Whereas annual direct costs of treatment for mental illness

and substance abuse disorders are estimated at

$68,000,000,000 and annual indirect costs due to lost

productivity, lost employment, vehicular accidents, criminal activity, and social welfare programs are estimated to

be approximately $250,000,000,000;

Whereas significant progress has been made within the last

10 years in research into the causes and treatments of

mental illnesses, and many such illnesses are now treatable;

Whereas significant numbers of persons with mental illness in

the United States find it difficult, if not impossible, to secure needed health care;

Whereas only approximately 20 percent of those in need of

mental health services actually receive them;
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Whereas mental health care is treated differently from care

for other health conditions in both public and private financing systems;

Whereas 99 percent of insured individuals and their families

have private health coverage for some inpatient mental

health treatment, but only 5 percent have coverage that

is equivalent to their coverage for other illnesses;

Whereas many private insurance programs continue to discriminate against individuals who suffer from mental illness or substance abuse disorders;

Whereas discrimination against individuals who suffer from

mental illness or substance abuse disorders continues to

exist in public insurance programs, including the Medicare program, which imposes a 50 percent copayment requirement for certain mental health care services but only

a 20 percent copayment requirement for all other part B

services;

Whereas businesses, consumers, and Federal and State governments are already paying for mental health care for

the uninsured and underinsured in an inefficient and inequitable and often more costly manner; and

Whereas the present system is structured to delay treatment

for mental illness and substance addiction until a condition requires hospitalization, the most expensive form of

health care and one that adds needless billions of dollars

to health care costs each year: Now, therefore, be it

1 Resolved by the House of Representatives (the Senate

2 concurring), That it is the sense of Congress that any

3 health care reform program enacted by Congress should

4 include provisions to prohibit discrimination in the provi-
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1 sion of and payment for health care services against indi2 viduals who suffer from mental illness or substance abuse,

3 including provisions—

4 (1) prohibiting discrimination in the assessment

5 of coinsurance, deductibles, premiums, or policy lim6 its relating to mental health and substance abuse

7 treatment services;

8 (2) prohibiting discrimination in the application

9 of managed care methods, including utilization re10 view and preferred provider networks, and ensuring

11 access to the spectrum of providers available; and

12 (3) providing as a general principle that any in13 dividual who suffers from mental illness or sub14 stance abuse must receive treatment comparable in

15 quality and comprehensiveness and as equally avail16 able as services received by an individual with a

17 physical illness or condition.

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