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John Kerry On Mental Health

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Public Statements

Speaker: Senator John Forbes Kerry (MA)
Title: Tribute to the Late Senator Paul Wellstone
Location: Washington, DC
Date: 10/24/2003
CONGRESSIONAL RECORD
SENATE
PAGE S13194
Oct. 24, 2003

Tribute to the Late Senator Paul Wellstone

Mr. KERRY. Madam President, I rise today in memory of my dear friend and colleague, Senator Paul Wellstone. A year ago today, the Senate—indeed, the Nation—suffered the tragic passing of Senator Wellstone. With his loss, his efforts to establish full mental health parity were cut short. It is now time to build on Senator Wellstone's historic achievements in this policy area and put an end to the discrimination faced by individuals with mental illness once and for all.

[Page S13205]

I was a proud cosponsor of the landmark Mental Health Parity Act, which Congress passed in 1996 at Senator Wellstone's urging. This law establishes parity for annual and lifetime dollar limit coverage for mental health treatment. While its enactment marked an important victory in the fight to provide greater mental health treatment benefits, it is time to take the additional steps needed to truly provide mental health parity for all Americans.

The Senator Paul Wellstone Mental Health Equitable Treatment Act of 2003 (S. 486) requires health insurance coverage to provide equal coverage of mental health benefits as it does for medical and surgical benefits. This legislation will improve access to care for individuals who are living with mental illness by closing the loopholes used by insurance companies to limit coverage. I am a proud cosponsor of this important legislation. It should be the law. I call on Senate leadership to bring this bill up for a vote without delay as a fitting tribute to the memory of Senator Wellstone.

I also urge the Senate to address the current discrimination in Medicare that seriously restricts seniors' access to mental health benefits. Under Medicare, seniors and people with disabilities pay a 20 percent copayment for all Part B services except for mental health care services, for which patients are assessed a 50 percent copayment. In other words, when seniors visit a cardiologist for heart disease, an endocrinologist for diabetes treatment, or an oncologist for cancer treatment, they pay a 20 percent copayment for the cost of the visit. If, however, a senior citizen or a person with disabilities seeks treatment for a debilitating and possibly life threatening mental illness, they pay for half of the cost of care out of their own pockets. Consequently, Medicare beneficiaries, many of whom are on fixed incomes, face an insurmountable barrier in seeking treatment that could substantially improve or prolong their lives because of a discriminatory policy that treats mental health services and medical services differently.

We need to put an end to what is essentially discrimination by diagnosis. I, along with my colleague Senator SNOWE, introduced legislation that phases down the 50 percent copayment for mental health care services to 20 percent over 6 years. This legislation, entitled the Medicare Mental Health Copayment Equity Act (S. 853), will establish parity in the Medicare program and improve access to care for our senior and disabled beneficiaries living with mental illnesses.

In the memory of my dear friend, Senator Wellstone, I urge my colleagues to consider this legislation, in addition to the Senator Paul Wellstone Mental Health Equitable Treatment Act of 2003. Together, these two bills will eliminate the stigma of mental heath and establish mental health parity in both the private and public sectors. I ask for your support and hope that together we can fulfill Senator Wellstone's passionate vision by ending mental health discrimination for all individuals.

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Public Statements

Speaker: Senator John Forbes Kerry (MA)
Title: Statements on Introduced Bills and Joint Resolutions S. 853
Location: Washington, DC
Date: 04/10/2003
S. 853. A bill to amend title XVIII of the Social Security Act to eliminate discriminatory copayment rates for outpatient psychiatric services under the medicare program; to the Committee on Finance.

Mr. KERRY. Mr. President, I am pleased to join my colleague Senator Snowe in introducing the Medicare Mental Health Copayment Equity Act. This legislation will establish mental health care parity in the Medicare program.
Medicare currently requires patients to pay a 20 percent co-payment for all Part B services except mental health care services, for which patients are assessed a 50 percent co-payment. Thus, under the current system, if a Medicare patient sees an endocrinologist for diabetes treatment, an oncologist for cancer treatment, a cardiologist for heart disease treatment or an internist for treatment of the flu, the co-payment is 20 percent of the cost of the visit. If, however, a Medicare patient visits a psychiatrist for treatment of mental illness, the co-payment is 50 percent of the cost of the visit. This disparity in outpatient co-payments represents blatant discrimination against Medicare beneficiaries with mental illness.

The prevalence of mental illness in older adults is considerable. According to the U.S. Surgeon General, 20 percent of older adults in the community and 40 percent of older adults in primary care settings experience symptoms of depression, while as many as one out of every two residents in nursing homes are at risk of depression. The elderly have the highest rate of suicide in the United States, and there is a clear correlation between major depression and suicide: 60 to 70 percent of suicides among patients 75 and older have diagnosable depression. In addition to our seniors, 400,000 non-elderly disabled Medicare beneficiaries become Medicare-eligible by virtue of severe and persistent mental disorders. To subject the mentally disabled to discriminatory costs in coverage for the very conditions for which they became Medicare eligible is illogical and unfair.

 

There is ample evidence that mental illness can be treated. Unfortunately, those in need of treatment often do not seek it because they are ashamed of their condition. Among our Medicare population, the mentally ill face a double burden: not only must they overcome the stigma about their illness, but once they seek treatment they must pay one-half of the cost of care out of their own pocket. The Medicare Mental Health Copayment Equity Act will phase-down the 50 percent co-payment for mental health care services to 20 percent over six years. By applying the same co-payment rate to mental health services to which all other outpatient services are subjected, the Medicare Mental Health Copayment Equity Act will bring parity to the Medicare program and improve access to care for our senior and disabled beneficiaries who are living with mental illness. I urge my colleagues to join with us to pass this critical legislation.

I ask unanimous consent that several letters of support be printed in the RECORD.

http://www.cq.com/display.do?dockey=/usr/local/cqonline/docs/html/crtext/108/crtext108-000000664392.html@crtext&metapub=CQ-CRTEXT&seqNum=29&searchIndex=1

 

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