I 
108TH CONGRESS 
1ST SESSION 
H. R. 953
To provide for equal coverage of mental health benefits with respect to 
health insurance coverage unless comparable limitations are imposed on 
medical and surgical benefits. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 27, 2003
Mr. KENNEDY of Rhode Island (for himself, Mr. RAMSTAD, Mr. SMITH of 
New Jersey, Mr. STARK, Mr. MURTHA, Mr. LANGEVIN, Mr. SERRANO, 
Mr. 
ABERCROMBIE, 
Mr. 
GEORGE
MILLER
of 
California, 
Mrs. 
NAPOLITANO, Ms. JACKSON-LEE of Texas, Mr. ANDREWS, Mr. BECERRA, 
Ms. BERKLEY, Ms. CARSON of Indiana, Mr. FARR, Mr. FATTAH, Mr. 
GREEN of Texas, Mr. GUTIERREZ, Mr. HOLDEN, Mr. LARSON of Con-
necticut, Ms. LEE, Mrs. MALONEY, Mr. MATSUI, Mr. MEEHAN, Mr. 
MENENDEZ, Mr. MOLLOHAN, Mr. MORAN of Virginia, Ms. NORTON, Mr. 
PALLONE, Ms. PELOSI, Mr. UDALL of New Mexico, Mr. WEINER, Mr. 
BISHOP of New York, Mr. CAPUANO, Mr. HOLT, Mr. MCDERMOTT, Mr. 
OWENS, Mr. STRICKLAND, Mr. BALLANCE, Mr. COSTELLO, Mr. GARY G. 
MILLER of California, Mr. RYAN of Ohio, Ms. WOOLSEY, Mr. LEVIN, Mr. 
CARDIN, Mr. CASE, Mrs. CHRISTENSEN, Mr. EMANUEL, Mr. ENGLISH, 
Mr. FOLEY, Mr. FRELINGHUYSEN, Mr. GILCHREST, Mr. HOEFFEL, Mr. 
HONDA, Mr. INSLEE, Mr. KIND, Mr. LATOURETTE, Mr. LEACH, Mr. 
MCNULTY, Mr. OBERSTAR, Mr. OLVER, Mr. RANGEL, Ms. SCHAKOWSKY, 
Mr. SCHIFF, Mr. WAXMAN, Mr. WYNN, Mr. DEFAZIO, Ms. DELAURO, 
Mr. DOGGETT, Mr. FROST, Mrs. JONES of Ohio, Mr. KILDEE, Mr. 
KLECZKA, Mrs. MCCARTHY of New York, Mr. MCHUGH, Mr. NADLER, 
Mr. PASTOR, Mr. SCOTT of Virginia, Mr. SKELTON, Mr. TIERNEY, Mr. 
VAN HOLLEN, Mr. ACKERMAN, Mr. BLUMENAUER, Mr. BRADY of Penn-
sylvania, Ms. DEGETTE, Mr. DICKS, Mr. DINGELL, Mr. LOBIONDO, Ms. 
MCCOLLUM, Ms. ROYBAL-ALLARD, Mr. SANDERS, Mr. SHAYS, Ms. 
SOLIS, Mr. BERRY, Ms. BORDALLO, Mr. BROWN
of Ohio, Mr. 
DELAHUNT, Mr. GREENWOOD, Mr. GRIJALVA, Mr. PASCRELL, Mr. 
PLATTS, Mr. QUINN, Mr. SAXTON, Mr. SIMMONS, Mrs. TAUSCHER, Mr. 
DOYLE, Mr. FORD, Mr. HINCHEY, Mr. RODRIGUEZ, Mr. VISCLOSKY, Mr. 
BURNS, Mr. DEUTSCH, Mr. ENGEL, Mr. ETHERIDGE, Ms. KILPATRICK, 
Mr. ROTHMAN, Mr. ALLEN, Mr. DAVIS of Florida, Mr. FALEOMAVAEGA, 
Mr. NORWOOD, Mr. TOWNS, Mr. BACA, Mr. CARSON of Oklahoma, Mr. 
PAYNE, Mr. PRICE of North Carolina, Mr. THOMPSON of California, Ms. 
WATSON, Mr. BERMAN, Mr. COOPER, Mr. DAVIS of Illinois, Mr. DAVIS
of Tennessee, Mrs. KELLY, Mr. KIRK, Mr. LARSEN of Washington, Mr. 
RAHALL, Ms. LORETTA SANCHEZ of California, Mr. WAMP, Mr. CLY-
BURN, Ms. HOOLEY of Oregon, Mr. KUCINICH, Mr. BOEHLERT, Mr. 
MATHESON, Mr. ORTIZ, Ms. SLAUGHTER, Mr. SNYDER, Mr. WALSH, Mr. 
MURPHY, Mr. SWEENEY, Mr. LIPINSKI, Mr. MCGOVERN, Mr. BAIRD, Mr. 
STUPAK, Mr. WILSON of South Carolina, Mr. BOUCHER, Ms. CORRINE 
BROWN of Florida, Mrs. CAPPS, Mr. CONYERS, Mrs. DAVIS of California, 
Mrs. LOWEY, Mr. PETERSON of Minnesota, and Mr. SABO) introduced 
the following bill; which was referred to the Committee on Education and 
the Workforce, and in addition to the Committee on Energy and Com-
merce, for a period to be subsequently determined by the Speaker, in 
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned 
A BILL 
To provide for equal coverage of mental health benefits with 
respect to health insurance coverage unless comparable 
limitations are imposed on medical and surgical benefits.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Senator Paul 
Wellstone Mental Health Equitable Treatment Act of 
2003’’ . 
SEC. 2. AMENDMENTS TO THE EMPLOYEE RETIREMENT IN-
COME SECURITY ACT OF 1974. 
(a) IN GENERAL.—Section 712 of the Employee Re-
tirement Income Security Act of 1974 (29 U.S.C. 1185a) 
is amended to read as follows:
‘‘SEC. 712. MENTAL HEALTH PARITY. 
‘‘(a) IN GENERAL.—In the case of a group health 
plan (or health insurance coverage offered in connection 
with such a plan) that provides both medical and surgical 
benefits and mental health benefits, such plan or coverage 
shall not impose any treatment limitations or financial re-
quirements with respect to the coverage of benefits for 
mental illnesses unless comparable treatment limitations 
or financial requirements are imposed on medical and sur-
gical benefits. 
‘‘(b) CONSTRUCTION.—
‘‘(1) IN
GENERAL.—Nothing in this section 
shall be construed as requiring a group health plan 
(or health insurance coverage offered in connection 
with such a plan) to provide any mental health bene-
fits. 
‘‘(2) MEDICAL
MANAGEMENT
OF
MENTAL 
HEALTH BENEFITS.—Consistent with subsection (a), 
nothing in this section shall be construed to prevent 
the medical management of mental health benefits, 
including through concurrent and retrospective utili-
zation review and utilization management practices, 
preauthorization, and the application of medical ne-
cessity and appropriateness criteria applicable to be-
havioral health and the contracting and use of a net-
work of participating providers.
‘‘(3) NO
REQUIREMENT
OF
SPECIFIC
SERV-
ICES.—Nothing in this section shall be construed as 
requiring a group health plan (or health insurance 
coverage offered in connection with such a plan) to 
provide coverage for specific mental health services, 
except to the extent that the failure to cover such 
services would result in a disparity between the cov-
erage of mental health and medical and surgical 
benefits. 
‘‘(c) SMALL EMPLOYER EXEMPTION.—
‘‘(1) IN GENERAL.—This section shall not apply 
to any group health plan (and group health insur-
ance coverage offered in connection with a group 
health plan) for any plan year of any employer who 
employed an average of at least 2 but not more than 
50 employees on business days during the preceding 
calendar year. 
‘‘(2) APPLICATION OF CERTAIN RULES IN DE-
TERMINATION OF EMPLOYER SIZE.—For purposes of 
this subsection—
‘‘(A) APPLICATION OF AGGREGATION RULE 
FOR EMPLOYERS.—Rules similar to the rules 
under subsections (b), (c), (m), and (o) of sec-
tion 414 of the Internal Revenue Code of 1986