Rochester Post Bulletin: New law equalizes mental health insurance coverage

By Jeff Hansel
Post-Bulletin, Rochester MN



Insurance that covers 80 percent of the cost for an appendectomy might pay only 50 percent for mental-health care.

After a decades-long battle, that disparity is about to change.

The Paul Wellstone Mental Health and Addiction Equity Act used the $700 billion economic rescue package to gain enough votes. Along with financial rescue came federally mandated insurance equality for people with mental illness.

"Finally it's being recognized," said Pat Schwartzhoff of Rochester, who has experienced depression and talks at school assemblies about mental illness. The bill passed in October and was signed into law by Pres. George W. Bush.

The mental-health equality portion of the bill is just as significant for many people as the Americans with Disabilities Act, which in 1990 banned discrimination against people with disabilities.

Mental illness insurance coverage must now equal coverage for physical illness.

Minnesota's Sen. Paul Wellstone, who died in a 2002 plane crash, fought to pass such legislation, but the needed votes eluded him before his death.

"I am absolutely proud that it's named after my father," said the late senator's son, Dave Wellstone.

The younger Wellstone started working to get the bill passed right after the plane crash that killed his parents, sister and five others.

"We all know somebody with a mental illness or who suffers from addiction," Wellstone said. "This is going to be groundbreaking."

The bill doesn't require that mental health be covered. Instead, it simply requires that, if physical health is covered, that mental health is covered at the same level.

"If it's offered now, then it will have to be brought up to par with the physical illnesses," Wellstone said.

The bill lagged for many reasons, he said. For one, there's a lot of stigma related to mental illness.

"To be able to help leave that legacy that's now in law, it's kind of a way to make sense of things," Wellstone said.

Working for the bill helped him heal.

"When you lose your family, you try sometimes to make sense out of it, and try to have good things happen," Wellstone said.

Pat Schwartzhoff's husband Earl, 64, said he worked as a health-insurance company manager for more than 25 years, supervising, at one point, three states.

"If you have an appendectomy, with most insurance companies, the claim will be handled easily," he said. Not so with mental illness. Two sets of rules exist, one for mental and one for physical health.

"They will quiz you, for lack of a better word. It's like they question the diagnosis of your doctor and you have to jump through so many hoops," Schwartzhoff said.

The new national law takes effect in 2010.