NMHA Legislative Alert
August 4, 2005

August Presents Advocacy Opportunities on Pending Legislation

Need to Promote Medicaid, Other Mental Health Funding
AHP Legislation Gains, Poses Danger


As we reported in NMHA's July 29 Legislative Alert, we expect Congress in September to consider legislation to reduce federal Medicaid spending and, accordingly, urged that advocates press members of Congress while they are home for the August recess to oppose any changes to Medicaid that will harm those who need support from this vital program. In addition to raising this critical concern over Medicaid, the August recess period may also provide an opportunity -- such as at Town Hall meetings -- to bring up other important pending mental-health issues.

In addition to emphasizing the importance of Medicaid to people with mental illness, we urge advocates to highlight the following messages in meetings or question/answer sessions with Members of Congress:


Pass mental health parity legislation:
Status: H.R. 1402, the Paul Wellstone Mental Health Equitable Treatment Act, introduced by Rep. Jim Ramstad in the House of Representatives would provide for both mental health and substance abuse parity, and has 191 co-sponsors. Parity legislation has not been introduced in the Senate this year. Please urge Members of the House of Representatives to co-sponsor H.R. 1402.


Reject Association Health Plan legislation pending in the Senate.
Status: Following up on NMHA's Legislative Alert of July 18, federal legislation (H.R. 525) that would exempt certain health plans from state insurance laws (including state parity laws) passed the House of Representatives by a vote of 263-165. This measure would provide unique de-regulatory treatment for health plans created by small-business associations, effectively denying important consumer protections to people covered by those plans. (Another bill discussed in our alert, H.R. 2355, which would eliminate state consumer protections for individually-purchased health plans. Although this legislation had been slated for a vote in the House of Representatives last week, it was pulled from consideration; its future is uncertain.).

The Senate will determine the fate of any association health plan (AHP) legislation, and we therefore urges advocates to convey to Senate offices strong opposition to AHP legislation UNLESS its provisions ensure that:
(a) state consumer-protection laws (including mental health parity laws) apply to AHP's;
(b) affordability of coverage is guaranteed, such as through state laws that govern premiums (and prevent them from soaring);
(c) the solvency of AHPs is guaranteed (during the 1970's, similar exemptions of AHP's from state requirements left policyholders with millions of dollars in unpaid medical claims).
(d) a substantial number of currently uninsured individuals would receive coverage under the bill. (Numerous studies have indicated that under legislation like HR 525, relatively few uninsured individuals would receive coverage under these changes.)


Provide initial funding to implement a new law to de-criminalize mental illness.
Status: Late last year, Congress passed legislation -- the Mentally Ill Offender Treatment and Crime Reduction Act (Public Law 108-414) developed by Sen. Mike DeWine (R-OH) and Rep. Ted Strickland (D-OH) -- that authorizes up to $50 million annually in Justice Department grants to help states and local communities. These grants would fund collaborative efforts (such as establishing diversion and treatment programs) among the criminal justice, juvenile justice and mental health systems aimed at ending the criminalization of people with mental illnesses. In order for this new initiative to be implemented, Congress must provide funding – which appears promising but not assured -- through the Commerce-Justice-State appropriations act. Grassroots support for such funding would be very helpful.


Maintain, and if possible, increase federal funding for needed programs and services for people with or at risk of mental illness
Status: While the process is not over, congressional action on federal funding – bowing to advocacy efforts -- has to date largely rejected the Administration's proposed deep cuts in funding for programs that support people with or at risk of mental illness. For example:


Funding for programs administered by the Center for Mental Health Services (CMHS), which were slated for a $64 million (seven percent) cut under the Administration's proposed budget, would be restored to last year's level under the bill adopted by the Senate Labor/HHS Appropriations Subcommittee. Under the House-passed version, CMHS funding would be trimmed by a smaller, but still substantial amount --$21 million. We urge support for the higher Senate funding level.
In taking up the funding bill for the Department of Housing and Urban Development, the Senate appropriations subcommittee for that account rejected an Administration-proposed 50 percent cut for the Section 811 program of supportive housing for people with disabilities. (The House had earlier rejected that plan as well.) The Senate subcommittee went further to allow Section 811 funding for next year to be used in full for new project-based grants. We urge strong support for the Senate provision.
Although the administration proposed a nearly 50 percent cut (a reduction of $160 million) for juvenile justice programs at the Department of Justice Office of Juvenile Justice and Delinquency Prevention (DOJ), congressional action to date would restore the proposed cuts and fund these programs at last year's funding level of $340 million. The juvenile justice programs include treatment services, educational projects, counseling, training, mentoring programs, as well as enhanced accountability of the juvenile justice system. We urge full restoration of juvenile justice funding. Thank you for your ongoing advocacy to protect and strengthen federal mental health-related programs.

(Please contact Ralph Ibson, Vice President for Government Affairs, at ribson@nmha.org or 202-675-8388 with any questions regarding this update.)

Marge Parrish
Special Projects Coordinator
Mental Health Association
314/773-1399