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07/30/96 09:40 OMB AD HP 5. 002 002 07/29/96 18:25 JL.1-04-56 16:44 FROM.CBO/BAD/HRCEU ID.202 226 2820 PAGE 1/3 TO: Dean Rosen, Rebecca Jones FROM: Jeff Lemieux, CBO SUBJ: Preliminary Federal Cost Estimate: Limited Mental Health Parity Proposal DATE: 6/4/96 I have attached a preliminary federal cost estimate of your proposal for a limited parity for mental health parity. Over the ten years between 1997 and 2006, CBO and the Joint Committee on Taxation (JCT) estimate that the revised proposal mental health parity would increase the deficit by about $1.9 billion The revised proposal is different from the proposal in the Senate-passed plan in several ways. Substance abuse benefits would not be subject to any mandates for parity, Parity would apply only to two types of insurance items as specified in the proposal: 1. Aggregate lifetime limits DRAFT 2. Aggregate annual limits Plans serving employers with 25 or fewer employees would be exempt, Plans would be allowed to have separate insurance products for mental and medical health coverage, with more stringent thresholds of management for mental health care, and Medicare and Medicaid would be exempt (In its previous estimate, CBO had assumed that these last two clarifications would be made as the legislation progressed Therefore, they do not change the federal cost estimate.) The Congressional Research Service estimates that premiums for a typical fee-for-service plan using customary management teclmiques to control costs would initially increase by 0.4 percent under this proposal. This estimate has not been adjusted for the impact the proposal would have on certain managed care plans or the fact that employers with 25 or fewer employees would be exempt Both adjustments could lower the estimated cost of 06-04-96 04:55PM P001 #20