The dawn of a new decade signaled the start of a new parity law in the United States

By Jennifer Pellegrini

In 2008, Barack Obama was a junior senator from Illinois-a dynamic idealist who had yet to coin the phrases "Yes We Can" or "Audacity of Hope," but who himself had the audacity to hope that a man of mixed race could hold the highest office in his nation.
A center-left Democrat, Obama championed causes many of those on the opposite end of the political spectrum did not. Among those was providing health care for some of the most marginalized in society: people living with mental illness.

During his Presidential bid in 2008, Obama's campaign team laid out his platform on the need for affordable mental health care in America.

"Mental illness affects approximately one in five American families, and we must do more to address this issue," said Obama in a statement to Mental Health Notes, which was reposted on PsychCentral.com. "The National Alliance on Mental Illness estimates that untreated mental illnesses cost the U.S. more than $100 billion per year. As a member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, I worked to improve mental health services for people with serious problems who are going untreated and undiagnosed."

On December 24, 2009, the United States Senate passed HR 3200, America's Affordable Health Choices Act of 2009 by a margin of 60-39. Every Democratic senator voted in favor of the bill, known to most as the Health Care Reform Act. Every Republican senator opposed it. In the weeks leading up to the vote, Senate Majority Leader Harry Reid (D-Nevada) brokered deals to ensure the bill would pass.

Obama praised the Senate for moving a step closer to enacting what he called "the most important piece of social legislation since the Social Security Act was passed in the 1930s."

"We are now finally poised to deliver on the promise of real, meaningful health insurance reform that will bring additional security and stability to the American people," he said.

But all of Reid's wrangling may go for naught.

Despite the hyperbole surrounding what could be the largest expansion of health care in the United States in four decades, the bill must now be merged with a $1-trillion plan passed by the House of Representatives in November. Even if the merger is seamless, passing the bill will prove more difficult after Massachusetts residents voted in a Republican senator in January.

It's the first time a Republican senator has held the seat since 1926; it had been vacant since Sen. Edward Kennedy-believed by many to be the grandfather of health care reform-died of brain cancer in September 2009. Kennedy and his brother, President John F. Kennedy, held the seat for a combined 56 years. In an instant, the state suddenly turned from blue to red, tipping the balance in the Senate and making final passage of the Health Care Reform Act a little less of a "Christmas miracle" than the U.S. media deemed it to be.

But that may not matter, either.

Americans were still celebrating the beginning of a new decade when the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 quietly came into effect on New Year's Day, 2010. Little has been said about it since it came into effect, but it was widely celebrated in 2008, particularly by Wellstone's children.

"Amazing. I want to pinch myself," Wellstone's son David told Minnesota National Public Radio (NPR) after the bill passed. "In my family, this was a huge moment. To have my dad's legacy be this law is a great thing."

Equal and for all
While health care reform has gotten all the press, Wellstone-Domenici actually has the teeth to make a real difference in the lives of people living with mental illness by closing the loopholes in insurance coverage for mental health services.

The bill was co-sponsored by Obama in 2007, 11 years after Paul Wellstone (D-Minnesota) and Pete Domenici (R-New Mexico) first introduced it in 1996. It passed a year later, six years after Wellstone died in a plane crash.
In a nutshell, the bill-which has become a part of HR 3200-requires insurance carriers to treat physical ailments and mental illness and addiction equally.

"It is important to end discrimination against those with mental illness," Obama said the summer before the bill passed. "I also support mental health parity. When suicide is responsible for more deaths in America than AIDS and homicides combined, we must act. That's why I have championed efforts to improve awareness of mental illnesses and provide timely and appropriate treatment, and why I co-sponsored the Mental Health Parity Act of 2007. Parity means that we don't allow group health plans to impose treatment or financial limitations on mental health benefits that are different from those applied to medical or surgical services. The bill closes the loopholes that allow discrimination in coverage that does not apply to other illnesses."