Bush Official Blasts House Mental Health Benefits Bill

Mr. Campbell said the legislation contained "very confused" language regarding Employee Retirement Income Security Act (ERISA) pre-emption. Two provisions, according to Mr. Campbell, seem to allow states to impose mandates, while another seems to try and ensure that the status quo will be maintained. "What appears certain," he said, "is that it will be litigated," leaving the courts to try and interpret congressional intent.

Further complicating the legislation, Mr. Campbell said, is it's treatment of genetic nondiscrimination, and more specifically, the remedies the legislation would create.

Mr. Campbell said the House bill would put issues regarding genetic conditions, which he views as a benefits dispute, into the category of employment discrimination, which carries significantly higher remedies.

State attempts to add mandates to plans are a major concern for the Department of Labor, Mr. Campbell said, noting that the administration has argued several cases on the issue. He pointed to a Maryland law that would have required large employers, and specifically included Wal-Mart, to pay a minimum percentage of a payroll for health benefits, or pay the differential to the state.

"This clearly interferes with uniform regulation of employee benefit plans, which is a core of ERISA," he said. The Maryland law was struck down by the courts, he noted, but a similar situation has arisen in San Francisco, and the 9th U.S. Circuit Court of Appeals has refused to uphold a stay barring a proposed mandate in the law to be enforced while the case plays out.

"You could only imagine" the results if states and even municipalities are given the ability to impose their own mandates, Mr. Campbell said. Employers would be required, among other things, to keep extensive records on employees and where they worked to ensure compliance with any number of different requirements. "These are the kinds of things that ERISA was intentionally designed to prevent," he said.

Unlike the House bill, the benefits bill that the Senate has passed was 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.

The House bill would not apply to health plans sponsored by an employer with 50 or fewer employees, nor would it apply to coverage in the individual insurance market.

According to officials of America's Health Insurance Plans, which represents health insurers, and the American Benefits Council, which represents employers, the Senate bill would give insurers more leeway on the types of mental disorders they would have to cover.

The House bill was sponsored by Reps. Patrick Kennedy, D-R.I., who says he has battled depression, alcoholism and drug abuse, and Jim Ramstad, R-Minn., a recovering alcoholic who is Mr. Kennedy's Alcoholics Anonymous sponsor.

The Senate bill was sponsored by Mr. Kennedy's father, Sen. Edward Kennedy, D-Mass., and Senators Pete Domenici, R-N.M., and Mike Enzi, R-Wyo. The two Kennedys will negotiate on the measure.

According to ABC officials, the Senate measure would avoid an all-or-nothing approach.

"The House bill will put us in the awkward position of either covering everything in the professional manual, or covering nothing at all," according to Neil Trautwein, health care lobbyist for the National Retail Federation.