The House is scheduled to vote tomorrow on the Paul Wellstone Mental Health and Addiction Equity Act (H.R. 1424), a bill championed by Reps. Patrick Kennedy (D-RI) and Jim Ramstad (R-MN) to end discrimination in insurance for mental health and addictive disorders. With bi-partisan support, spending offsets worked out, and 273 co-signers, it is likely to pass.

It then goes to a joint committee where differences with the Senate’s bill (S 558) will presumably be ironed out. The differences are significant.

The Wellstone Equity Act, considered the more comprehensive of the two bills, would use the universally employed medical criteria for psychiatric illnesses, including substance addictions, found in the DSM to define coverage. The Senate’s bill, on the other hand, gives businesses and insurance companies the authority to write the criteria.

The Senate’s plan allows human resource officers to set independent criteria for reimbursements for treating depression, eating disorders, panic attacks, psychosis, schizophrenia, mania or addiction (and many others). It would be folly to allow employers to use different criteria that may or may not conform to evidence-based treatments. Or to prevent doctors from individualizing treatment depending on the unique health needs of each patient.

It difficult to take the objections of business and the insurance industry seriously when their lobbying agent, ERIC, trivializes the benefits of the Wellstone Equity Act. "If H.R. 1424 were made law, providers would be entitled to employer plan reimbursement for treating ailments such as jet lag, shyness, poor academic achievement, and sibling rivalry," said ERIC spokesperson Edwina Rogers.

On-line materials from ERIC’s web site spell out its lobbying mission as: “the only organization dedicated exclusively to representing the employee benefits and compensation interests of America’s major employers.”

Whatever changes are made when the House and Senate sit down to resolve differences, it is important to remember the proposed bills cover only those receiving coverage from businesses with 50 or more employees. A huge number of Americans will be left out because they are self-employed, work for mama-and-papa restaurants, grocers or dry cleaners, or otherwise do not qualify. Still, the bill should cover a sizable proportion of the estimated one-in-five Americans who have mental health and addictive disorders needing attention.

It is time to pass the Wellstone Equity Act, and then work to make sure its principles extend to everybody.