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And I'm Steve Inskeep.
Today, the House takes up a bill that would require health insurers to provide the same coverage for mental illness as for physical ailments. Congress has tried to do this before and failed. And you see the challenges now when you look at the differences between two lawmakers, a father and son.
Here's NPR's Julie Rovner.
JULIE ROVNER: Most people don't know until they actually need mental health care that many health insurance plans don't provide coverage as generous for psychiatric conditions as they do for physical ones.
Two presidents and a bipartisan majority in Congress have been trying to rectify that situation for a dozen years now, pushing a bill that would require parity between mental and physical health insurance benefits. Business and insurance groups have long resisted, afraid it would boost costs.
Early last year, it looked like victory was at hand, thanks to a hard-won compromise between mental health, insurance and business groups. That came as a huge relief to long time sponsors like New Mexico Republican Senator Pete Domenici.
Senator PETE DOMENICI (Republican, New Mexico): The bill was supported openly by all the associations of any significance, like NAMI.
ROVNER: That's the National Alliance on Mental Illness.
Sen. DOMENICI: And all the companies that issued insurance and companies that bought big time insurance, like General Motors, etc. They all bought this approach. So we really thought we had it and that nothing more had to be done.
ROVNER: Nothing, that is, besides getting the bill passed by the Senate and House. The Senate went first, with Massachusetts Democrat Edward Kennedy, Domenici's co-sponsor, pushing the measure through his committee last spring, and then through the full Senate last September.
But a funny thing happened when the bill got to the House. Sponsors there, including Kennedy's son Rhode Island Democratic Congressman Patrick Kennedy, decided not to take up the Senate's carefully negotiated bill.
We reached the younger Kennedy on his cell phone.
Representative PATRICK KENNEDY (Democrat, Rhode Island): Our approach has been more ambitious because we felt that we had an opportunity, given the rules of the House, to go further in the effort to provide even more comprehensive mental health coverage.
ROVNER: And Congressman Kennedy isn't the only one who didn't embrace the Senate compromise. David Wellstone co-founded Wellstone Action with his brother after their father, Minnesota Democratic Senator Paul Wellstone, was killed in a plane crash in 2002.
Paul Wellstone had originally teamed with Senator Domenici to try to pass a mental health parity bill. But David Wellstone refused to allow this year's Senate bill to be named after his father, as earlier versions were. He says the Senate measure simply doesn't guarantee enough coverage.
Mr. DAVID WELLSTONE (Wellstone Action): My dad always believed you can't leave people out. You can't have people like Kitty Weston, who was his friend and my friend, whose daughter had an eating disorder and went in and was told we have to figure out if this is a medical necessity.
ROVNER: That's because while the Senate bill does require parity between mental and physical health coverage, it still allows insurers to limit the types of mental ailments they cover. The House bill is much broader. It doesn't require that insurers offer mental health coverage, but if they do, it would have to be much more comprehensive than many plans offer now.
But that could pose a problem of its own, say mental health groups that support the Senate approach. Andrew Sperling represents the National Alliance on Mental Illness. He says he fears the House bill might unintentionally override state laws that now require some mental health coverage, but only of serious mental illnesses like major depression of schizophrenia.
Mr. ANDREW SPERLING (National Alliance on Mental Health): You would have families that now have guaranteed coverage under their state law would, under a new federal standard, have their employer have the option of eliminating all mental health benefits.
ROVNER: Then there's just plain politics. Senate sponsors say the House bill simply can't pass the upper chamber. Representative Patrick Kennedy says he thinks that's not true, but he says he's willing to compromise, anyway.
Rep. KENNEDY: I'm not an all-or-nothing person. I want something, and then I can add to it next year and the year after and the year after that. That's the way Congress works. I've watched my father over the years. I've taken lessons.
ROVNER: He's going to need them. Once the House passes the bill, he'll be at a negotiating table across from his dad.
Julie Rovner, NPR News, Washington.
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