Projo Politics Blog

WASHINGTON, D.C. -- Despite overwhelming shows of support in both houses of Congress yesterday, there remains much uncertainty about the fate of the campaign for better medical treatment of mental illness.

From House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid to the insurance lobby and advocates for the mentally ill, all involved in the drive for "mental health parity'' have joined in the plaudits for the leading sponsors of the legislation, including Representatives Patrick J. Kennedy, D-R.I., and Jim Ramstad, R-Minn., and Senators Edward M. Kennedy, D-Mass., Pete V. Domenici, R-N.M., Mike Enzi, R-Wyo., and Christopher J. Dodd, D-Conn.

"This long-overdue legislation has brought mental illness and addiction out of the shadows and to the forefront of our work here in Congress,'' Pelosi said in a statement last night after the House passed one version of the bill by a vote of 376 to 47. "By requiring that illness in the brain be treated just like illness anywhere else in the body for insurance purposes, we are helping to end discrimination against those who seek treatment for mental illness and saving lives,'' she said.

Patrick Kennedy and his allies prefer that this House version of the parity bill -- which would require insurers to cover mental illness on an equal footing with physical illness or injury -- become law. It incorporates a compromise approach to the problem struck months ago by House and Senate negotiators, plus a method of covering the cost of the bill, estimated at more than $3 billion.

But the extraordinary deadline pressure to pass an emergency bailout of the financial system has complicated all the other business before the Congress this week, including the mental health bill. The "stand-alone'' House parity bill is therefore awaiting its possible turn in line for Senate action under a special procedure that requires unanimous agreement without much time-consuming debate or a roll-call vote. That means any sort of objection by any senator could kill it.

If the stand-alone bill is to win Senate passage, chances are that it will happen today.

If obstacles to the stand-alone House bill appear in the Senate today, the supporters of the mental health bill are likely to shift to a more complicated alternative path to enactment. That means focusing on a large package of tax measures that passed the Senate last night with the mental health parity measure as an attachment.

The so-called "tax-extenders'' bill -- parity included -- cleared the Senate on a 93 to 2 vote because it includes some very popular provisions, such as a measure to reduce the burden of the alternative minimum tax on the middle class. But difficulty looms in the House because some Democratic budget hawks object to the various payment mechanisms in the overall package.

House leaders have therefore decided to break the tax-extenders bill into pieces to improve the chances for passage of the most popular provisions. But that means changes in the form of the legislation, which the Senate would have to accept in subsequent votes.

Parity supporters remained uncertain this morning about which chunk of the tax bill to use as a fallback vehicle for their mental health bill, in the event that the simple stand-alone version stalls in the Senate.

Keep track of the House bill's progress here.

 Tags  mental health parity bill Rep. Patrick Kennedy

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