WASHINGTON – The House voted Wednesday to require equal health insurance coverage for mental and physical illnesses when policies cover both.
The 268-148 roll call was cheered by advocates who have been fighting more than a decade for what has come to be called mental health parity.
Supporters said the measure would help end the stigma of mental illness and create greater access for people needing mental health and addiction treatment.
Opponents warned it could drive up health care costs and force some employers to drop insurance coverage.
The "Paul Wellstone Mental Health and Addiction Equity Act of 2007" was named for the late Minnesota Democratic senator who championed the issue for years and who was killed in a 2002 plane crash.
"It's a historic step," said the late senator's son, David, 42. "It's a civil rights bill for people with mental illnesses and chemical addiction. It forces insurance companies to treat them as they treat others."
Forty-seven Republicans joined 221 Democrats in voting for the bill. Three Democrats voted against it.
The House vote sets the stage for talks with the Senate, which passed a narrower version of the bill last September with support from business and insurance groups.
The White House said it favors the Senate bill because it addresses the need to treat mental illnesses with the same urgency as physical illnesses but wouldn't significantly raise health care costs.
The House bill was sponsored by Reps. Patrick Kennedy, D-R.I., who has battled depression, alcoholism and drug abuse, and Jim Ramstad, R-Minn., a recovering alcoholic who is Kennedy's Alcoholics Anonymous sponsor.
"It's about opening up the doors and ending the shadow of discrimination against the mentally ill," said Kennedy.
Former first lady Rosalynn Carter, a longtime mental health advocate, said the bill would help erase the stigma of mental illness that prevents many people from seeking treatment.
The Senate bill was sponsored by Kennedy's father, Massachusetts Democrat Edward Kennedy, along with GOP Sens. Pete Domenici of New Mexico and Mike Enzi of Wyoming.
The younger Kennedy will negotiate with his father on a compromise measure.
"We've discussed strategies and ways we can try to move this," the congressman said.
The House measure specifies that if a plan provides mental health benefits, it must cover mental illnesses and addiction disorders listed in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, which is used by mental health professionals.
The Senate bill gives insurers more leeway on the types of mental disorders they would have to cover.
Rep. Phil Gingrey, R-Ga., complained the House bill would mandate coverage for such conditions as jet lag and sexual dysfunction that are listed in the psychiatric association's manual.
"Can you imagine any employer being willing to cover things like that?" said Gingrey, a doctor.
Opponents said because the House bill requires much broader coverage than the Senate bill, it would prevent some businesses from providing any mental health coverage at all.
"The House bill will put us in the awkward position of either covering everything in the professional manual — or covering nothing at all," said Neil Trautwein, the National Retail Federation's health care lobbyist.
The federation, a trade association for the retail industry, favors the Senate version.
The Senate bill was a compromise reached after negotiations with businesses, the insurance industry and mental health advocates. Business and insurance groups had fought previous versions, arguing the proposals would drive up insurance costs.