Texas Mental Health Parity Laws: Legislative History
I haven't had time to properly interlink these pages; to
navigate, use back browser or return (go to if not initially
there) the main index page of this section of mmy site.
Garnet Coleman, member of House of Representative (Texas state)
was sponsor or author of both 1997 and 1999 mental health parity
bills. Room E1.408, Capitol Extension, Austin TX 463-0524.
Caton Fenz his legislative director. home office; 5445 Alameda
Suite 403, Houston 713-520-5355.
TALK TO THE AIDE WHO WORKED ON THESE BILLS.
ASK COLEMAN'S OFFICE FOR THE STATS OR SOURCES ON FROM WHERE
CAME KNOWLEDGE THAT PEOPLE NEED EQUAL COPAYS FOR MENTAL
HEALTH CARE THAT LED TO CHANGE IN LAW IN 1999.
ASK COLEMAN'S OFFICE FOR THE SOURCE OF THE NOTION THAT MANY
EMPLOYERS ARE PROVIDING COVERAGE, MANY COMPUTER COMPANIES
PROVIDING COVERAGE - HOW DO WE KNOW THIS TO BE TRUE, WHERE
DID THIS STATEMENT COME FROM? wHAT IS ITS SOURCE?
Also, Glen Maxey, 463-0552. local state legislator,
very helpful in negotiating the system, has worked alot on
funding and medications for mental health care.
Brent Biggs his aide working on this stuff
The bills:
Find copies of the 1997 and 1999 bills at Capitol Web Site or
Legislative Reference
under names of the houses, bill information. For 1993 on.
Another legislative/ agency reference: Texas State Library
includes their card catalog that SUPPOSEDLY lists everything,
all owned by five different libraries in the Austin area.
I had a hard enough time finding anything that exists in it!
The reference librarian in the documents room was helping me -
and she did little better.
1991 bill that gave public workers parity; Sect 11.106, Chapt
343, Acts of 72nd legislature, Regular SEssion, 1991.
Redesignated Sect 3(a)(3). Texas Employees Uniform Group
Insurance Act.
A hearing was held on this "Hearing on Tex. S.B. 644 Before the
Senate Economic Development Committee. Subcomm. Ins, 72d
Leg., R.S. (April 4, 1991). Hearings available in tape form
at state library documents room.
In 1995, a hearing was held on Coleman's parity bill, then
HB 2040. It was introduced 3/06/95, a hearing was held in
the Insurance Committee on 4/19/95, witness list is not
available, and it was left pending in committee. Committee
schedules are not available for that year, either, to determine
if a hearing was ever held in the Senate - but it does not
appear to have been assigned to Committee there.
1997 bill extending mental health parity to others w more than
50 employees for major mental illness,
HB 1173. Chapter 1371. 75th legislature. sponsor - Garnett
Coleman. Article 3.51-14
of Insurance Code. passed house 5/2/1997, Senate 5/22/1997,
Gov Bush is said to have had a special ceremony to sign it.
(not normally noted for being progressive about disabilities or
much else). Signed 6/20/97, took effect 9/1/97.
Committees: Senate Committee on Economic Development, House
Committee on Insurance.
The Senate Committee on Economic Development held a hearing on it
Tues May 13 1997 at which many people testified - a week after
it passed the House.
Another hearing supposed to be on 5/15. May also have been 5/18.
The House Insurance Committee held a hearing on it 3/17/97,
alot of people also testified at that.
Supposedly, a subcommittee held a hearing on it on 4/14/97 -
according to the action record on the bill. According to the
list of committee schedules there is just one subcommittee -
an oversight committee, and no schedule is available for it.
The Insurance Committee met on 4/14 - but I don't find HB 1173 on
the schedule, nor witnesses testifying about it.
House Insurance Committee witness list.
House Insurance Committee witness list (one of
these links should contain the correct url)
Witness list at the Senate hearing
It was quite long.
1999 bill making some improvements in both earlier laws:
HB 2424. Sect 3 (a) 19 TExas Employee Uniform Group Insurance,
and Article 3.50-2; also 3.51-14.
Passed House 5/4/99, passed Senate 5/20/99, approved 6/18/99
effective 9/1/99. Senate Committee on Economic Development (C510),
House Committee on Pensins and Investments (C395). Sponsored
by Coleman and Madla.
The House Committee on Pensions and Investments had a hearing on it
on Wed. 3/31/99 at 8 AM. Clerk of committee: Stephanie Muth,
463-2054, Ext E2.170. Sherri Greenberg, Chair. Juliane
Buron, also clerk. Noone testified.
The House Committee on Pensions and Investments supposedly had
a second hearing on it 4/7/99; they met but I find no record
of the bill there.
The Senate Committee on Economic Development held a hearing
on it on 5/13/99 at which only Connie Barron of TMA and
Rhonda Myron of TDI testified.
Stated subject headings:
10440 Insurance - Life, Health & Accident
10530 Mental Health & Mental Retardation
From health insurance consumer complaint line,
Texas Administrative Code 21.2401 discusses coordination
among the laws, implementation, the 1996 Federal parity law.
unfair claims practices and slow-paying/ no paying
that is Texas Administrative Code 21.55. The latter, anyhow.
Former also illegal. Both, you can file a complaint. She
cited this as an example of if a self-insured plan is
administered by a "third party" ie HMO or health insurance
company and they are doing something illegal. As long as the
employer forked over the funds, they have to process claims
promptly.
The Texas state law is very limited in its applicability due to interference from ERISA, which is a federal law that exempts several large categories of private employer-provided group insurance coverage from virtually all state level health insurance reform, in the name of allowing large employers to easily operate their plans without being hampered by differing state regulations.
There is incredible confusion about what exactly plans ERISA blocks from such state reform laws as Texas' mental health parity law. Many mental health advocacy pamphlets including NAMI's wrongly state that those plans that are exempt are those that are self-funded, ie, the employer himself pays the medical bills, AND the employer has branches in more than one state. Not so. All plans that are self-funded are exempt from the Texas state law. This affects anywhere from the employees 1/3 of all employers including selectively the largest employers, to one half of all the people in the United States. Further, multi-employer plans that are negotiated by unions,possibly specifically during collective bargaining are also exempt from state law. But some kinds of multiemployer plans are not exempt from state law. This is all goverend by a different section of ERISA then that which exempts employers who self-fund the medical coverage they provide; as nearly as I could find out,
that is sections 3 (40) and 3 (40A). ERISA is in the Federal Insurance law and takes up half of the three volumes of federal insurance law - together with its massive body of case law.
Unfortunately, the courts themselves are very confused by ERISA
and about what ERISA does and does not preempt. One key
distinction they ALMOST agree on; ERISA exempts only that portion
of an employer's coverage that is actually self-funded. If some
of his coverage is ordinary HMO or traditional insurance, that
is covered by the state mental health parity law.
The only way one can tell if one's health plan is self-funded by the employer is usually to ask. Most self-funded health coverage is administered by insurance companies and HMO's; you get your card from them and claims are submitted to them, and they process the claims and the bills, so you have no idea whether your plan is employer self-funded. Also, there is no
state agency where employers who self fund have to report that
fact or report any information or data about themselves. They
are supposed to file certain things with the Department of Labor
but I'm told enforcement is weak.
Many very large companies, like IBM and Dell, readily admit that they self- fund and zealously look out for their interests in
Congress. A large number of these companies belong to two
Washington lobbying groups who vigorously oppose any and all
measures in Congress that would at all weaken their ERISA
license to get away with whatever they want to. ERISA also,
for instance, is why patients cannot sue HMO's for negligence
or deliberate bad decisionmaking that leads to someone's death.
Most of these companies have gone to nominal mental health
parity via behavioral managed care, and zealously guard against
possible loosing ERISA exemptions on the grounds that they are
doing a good job! See my companies
page for lists of them.
These companies and their two lobbying groups regularly testify
before Congress and tell all sorts of info about themselves and
their agenda; SEe my list of
Congressional hearings on mental health parity and behavioral
managed care.
I have extensive information on ERISA and on behavioral managed
care at my national level resources page.
I've also been referred to a National Association of Insurance Commissioner's White Paper on ERISA, and to a report by the Texas Department of Insurance, "The State Mandates Report".
A state mandate is state level insurance reform.
Brian Shannon writes;
"Subsequent to the legislative initiative, the Texas Department
of Insuranc ehas taken additional steps to eradicate
discriminatory insurance treatment through regulatory action.
With respect to long-term care insurance,the state insurance
board has previously permitted insurers to limit or exclude
coverage for "mental and nervous disorders". Tex. Ins. Bd.,
28 TEX. ADMIN. CODE sect. 3.3826 (West Supp. Oct 1, 1991)
Recently, however, the board has proposed excepting "biologically
based brain diseases/ serious mental illness" (from the
exception for "metnal or nervous disorders" Tex. Ins. Bd.
17 Tex. Reg. 1511 (1992) (prop. amend. to 28 TEX. ADMIN. CODE
sect 3.3826.)
One good reference I found cited in the law code is,
Shannon, Brian D. "The Brain Gets Sick, Too -- The Case for
Equal Insurance Coverage for SErious Mental Illness",
24 St. Mary's L.J. 365 (1993). Brian Shannon's mother is
Jacqueline Shannon, then president of TEXAMI, she testified
at atleast one hearing in 1991. Even though it was 1993, he
has a complete explanation of the ERISA problem.
It seems Lynn Laskey should have known about this, too.
Brian Shannon is at Texas Tech University, Lubbock, Texas.
806-742-1355, brian.shannon@ttu.edu
He also wrote an update:
"Paving the path to parity in health insurance coverage for
mental illness", 68 Col. L. Rev. 63 (1997).
A key court case that was decided by
the Supreme Court is The District of Columbia vs. The Greater
Washington Board of Trade. (U.S. Supreme Court Reports, 121 L Ed 2nd (the lawyer's edition), 513 and 113 U.S. Supreme Court
Reporter, 580 (1992). Several justices wrote a nice dissent.
I have more court cases on ERISA, most current, at My Congressional hearings page
My own legislators
Congr District 10
Lloyd Doggett
202-225-4865
328 Cannon House Office Bldg
State Sen Distr 14
Sen Gonzalo Barrientos
CAP 3E 18
463-0014
House Distr 49
Repr Ellott Naishtat
Ext E2.808
463-0668.
E- refers to Capitol Extension.
Email me at dorasmith24@hotmail.com
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