After nearly thirteen (13) years of waging the battle at the federal level to get legislation passed that would recognize addictive disease disorder as a disease of equal merit with all others diseases covered by private health insurance, the battle was successful on October 3, 2008.
This a follow up to my Sept 28 article on addiction treatment parity, Parity Bill Passes Both Houses of Congress, But Final Approval Remains in Doubt . A friend forwarded me this text; he gave credit for it appearing on NAATP.org, the National Association of Addiction Treatment Providers.
Lost in the noise of the rumblings and reverberations of the $700 Billion dollar bail out package was the fact that the Economic Stabilization Act was welded to H.R. 1424 which was the House passed version of the parity bill.
Because of procedural issues, the Senate cannot initiate spending bills and therefore they had to attach the Economic Stabilization Act to a spending bill already passed by the House. Thus H.R. 1424 was passed by the Senate on October 2, 2008 and then passed by the House on October 3, 2008. We now have the Paul Wellstone and Pete Domenici Mental Health and Addiction Equity Act of 2008.
Since that time a great deal has happened and there has been little time to examine and focus on this part of the momentous event of October 3. Nevertheless, there are some lessons to be learned and some items we can anticipate.
The law itself will not go into effect until October 3, 2009 – One year from the date that it was signed. When law (legislation) are written, they are often seen as “guidelines or roadmaps” and the implementation is guided by the procedures which then accompany the legislation. It is a forgone conclusion that the procedures will not be written by the current administration and more than likely not for the first six months of the new administration that takes office in January 2009! The procedures will address the issues of transparency, medical necessity criteria, etc. A major struggle from the beginning of the parity discussion has been how much “mandate language” (access to treatment) could be included and how much of the language would be a position statement on parity.
The Paul Wellstone and Pete Domenici Mental Health and Addiction Equity Act of 2008 is a real cause for us to celebrate. Seldom has there been an issue which has galvanized the entire addiction treatment community in the way that this issue has. Seldom have we showed the focus that we did through this long and sometimes convoluted path to passage. It is time to congratulate each other and we deserve the congratulations!
But the battle is not over. Essentially we have passed legislation which is rock solid civil rights legislation. We have federal legislation which declares that it is illegal to discriminate against addictive disease disorders when providing insurance coverage for this disease. It is not a mandate requiring that this coverage be provided. Prior to the passage of this legislation, we did not have basic civil rights legislation making this declaration.
The next steps will be to impact the procedure writing process so that the intent of the legislation is breathed into the procedures. We can expect that the insurance industry and the coalition of small business associations will be equally interested in making sure that this legislation does not turn into a mandate bill. We can expect that however the procedures are written, it will change the conversations individual providers will have with insurance organizations and managed care organizations and the conversation that associations such as NAATP have with the insurance industry and with employers. The longer term impact of passage of the Paul Wellstone and Pete Domenici Mental Health and Addiction Equity Act of 2008 is that we now have a platform to stand on, a federal law which we can use to build our case in other areas.
October 3 was and is a day to celebrate. Not a day to retire all the research and arguments we will need going forward, but a day to celebrate what we have accomplished. Addictive Disease Disorders are now recognized via federal legislation as being on par with other covered diseases in insurance plans.
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