IV
103D CONGRESS
1ST SESSION
H. CON. RES. 59
Expressing the sense of Congress that any health care reform program en-
acted 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 ill-
ness 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;
•HCON 59 IH
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 ill-
ness 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 men-
tal 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 sub-
stance 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, crimi-
nal 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 treat-
able;
Whereas significant numbers of persons with mental illness in
the United States find it difficult, if not impossible, to se-
cure needed health care;
Whereas only approximately 20 percent of those in need of
mental health services actually receive them;
•HCON 59 IH
Whereas mental health care is treated differently from care
for other health conditions in both public and private fi-
nancing 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 dis-
criminate against individuals who suffer from mental ill-
ness 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 Medi-
care program, which imposes a 50 percent copayment re-
quirement 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 gov-
ernments are already paying for mental health care for
the uninsured and underinsured in an inefficient and in-
equitable and often more costly manner; and
Whereas the present system is structured to delay treatment
for mental illness and substance addiction until a condi-
tion 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
Resolved by the House of Representatives (the Senate
concurring), That it is the sense of Congress that any
health care reform program enacted by Congress should
include provisions to prohibit discrimination in the provi-
•HCON 59 IH
sion of and payment for health care services against indi-
viduals who suffer from mental illness or substance abuse,
including provisions—
(1) prohibiting discrimination in the assessment
of coinsurance, deductibles, premiums, or policy lim-
its relating to mental health and substance abuse
treatment services;
(2) prohibiting discrimination in the application
of managed care methods, including utilization re-
view and preferred provider networks, and ensuring
access to the spectrum of providers available; and
(3) providing as a general principle that any in-
dividual who suffers from mental illness or sub-
stance abuse must receive treatment comparable in
quality and comprehensiveness and as equally avail-
able as services received by an individual with a
physical illness or condition.
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