Proposals for Mental Health Parity Pit a Father’s Pragmatism Against a Son’s Passion

Father and son Kennedys introduce competing parity legislation:

It’s Kennedy versus Kennedy as two members of Congress from the same family face off over competing versions of legislation that would require many health insurance companies and employers to provide more generous benefits to people with mental illness.

Representative Patrick J. Kennedy, Democrat of Rhode Island and chief sponsor of the House bill, has criticized as inadequate the Senate bill introduced by his father, Senator Edward M. Kennedy, Democrat of Massachusetts. Representative Kennedy is trying to mobilize mental health advocates to lobby for what he describes as “the stronger of the two bills, the House bill.”

Both bills seek to end discrimination against people with mental disorders by requiring insurers and employers to provide equivalent coverage, or parity, for mental and physical illnesses.

That would be a huge change. For decades, insurers have charged higher co-payments and set stricter limits on coverage of mental health services. For example, insurers often refuse to cover more than 20 visits a year to a psychotherapist. And a patient may have to pay 20 percent of the cost for visiting a cancer specialist, but 40 percent or more for a mental health specialist.

The differences between the Kennedys’ bills reflect different views about what is possible and what is politically feasible.

Senator Kennedy said he was taking a pragmatic approach and had made a number of compromises to win the support of business and insurance groups. These compromises, he said, greatly increased the chances that a bill would become law, protecting millions of Americans in group health plans.

Insurers and employers had opposed similar proposals in the past, saying the plans would drive up costs. This year, however, Senator Kennedy invited employers and insurers to help write the legislation, along with mental health groups, and they have endorsed the bill that he introduced with Senator Pete V. Domenici, Republican of New Mexico. The bill was recently approved in a Senate committee by a vote of 18 to 3.