Acting on an executive order issued by President Clinton, the federal government will offer its 9 million employees, beginning today, improved mental health benefits equal to those for physical ailments.
Federal officials' embrace of equal insurance protection for mental and physical illnesses represents a significant victory for mental health advocates, who have argued for more than a decade that the widespread practice of providing less coverage for mental disorders is discriminatory.
The new policy also offers further evidence that the notion of equality in coverage is gaining wider acceptance. More than half the states have laws that address such insurance disparities, and many large corporations provide equal coverage for their employees, believing that doing so saves money in the long run.
The notion of equal coverage, referred to as parity, was also endorsed by Vice President Al Gore and President-elect George W. Bush during the presidential race.
"There has been definite progress," said Jennifer Heffron, senior director of state affairs for the National Mental Health Association, a nonprofit group.
Yet Heffron, echoing the concerns of other mental health groups, said that despite such advances, true equal coverage, in its fullest sense, remains elusive. She said that many state laws included so many restrictions that they had little effect and that in some cases insurance companies had found other, more subtle ways to limit coverage for mental illness.
In offering equal coverage, federal officials hope to provide a model for employers around the United States. The initiative is also likely to be monitored closely by Congress, which will probably take up the parity issue in its next session.
Under guidelines developed by the federal Office of Personnel Management, private health plans for federal employees will no longer impose higher copayments or deductibles for mental health services, or set limits on outpatient visits or hospital days for mental disorders that are lower than those applied to general medical or surgical care. Treatment for alcohol and drug abuse will also be covered equally under the new policy.
Even a decade ago, equal coverage for mental illness seemed more a pipe dream than a practical possibility.
Opponents, including the insurance industry and business groups, warned that without limits on mental health coverage, the "worried well" would spend endless years on the couch and health care costs would spin out of control, forcing many employers to give up health insurance altogether.
