[Pages H2659-H2660]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                TIMOTHY O'CLAIR AND MENTAL HEALTH PARITY

  (Mr. Tonko of New York was recognized to address the House for 5 
minutes.)
  Mr. TONKO. Mr. Speaker, I rise today to urge all of us to demand 
mental health parity enforcement in honor of a young man that I once 
represented, Timothy O'Clair.
  I first met Timothy when I served in the State Assembly in New York. 
Timothy played Little League and had a smile and spirit that burned 
incredibly bright. He played in the chess club and was an avid bowler.
  Timothy enjoyed gymnastics, playing the piano, fishing, golfing, 
boating, and drawing. He enjoyed the outdoors and was an avid animal 
lover. However, Timothy suffered from significant mental health 
challenges, and his family struggled along with him, fighting with 
insurance companies to get him the care he truly needed.
  The insurance companies didn't know the Timothy that I knew. Where we 
all saw an extraordinary little guy in a fight for his own life, the 
insurance company saw expenses in a ledger book. They put caps on his 
care and denied coverage for needed mental health treatment. When 
Timothy received the care he needed, he thrived. However, his family 
always knew that those caps and denials of coverage were right around 
the corner.
  Things got worse for Timothy. In order to get him the Medicaid 
coverage he needed, Timothy's parents were forced to legally disown 
him. Can you imagine being forced to make that decision in your own 
family? Unfortunately, for Timothy, even that was not enough.
  At 12 years old, Timothy completed suicide.
  Timothy's memory will never leave me. His spirit inspired me and a 
number of other committed advocates to write and advance Timothy's Law 
in New York State, one of the first mental health parity laws in our 
country.
  Specifically, Timothy's Law required parity in insurance plans 
between mental health and general health benefits.
  Passing Timothy's Law gave me the drive to improve the way that we 
approach mental health care in America nationwide.
  To me, that means reducing the stigma for those seeking care, 
addressing the growing problem of the youth behavioral health crisis, 
and giving our healthcare professionals the resources they truly need 
to adequately recognize and address the challenges those who live with 
mental illness must grapple with each and every day.
  It also means ensuring that parity is fully enforced.
  At the Federal level, the Paul Wellstone and Pete Domenici Mental 
Health Parity and Addiction Equity Act of 2008 sought to correct the 
imbalance between the benefits afforded mental health and substance use 
disorders under group health plans and general medical and surgical 
benefits typically afforded under such plans.
  Mr. Speaker, 15-plus years later, we still are seeing major gaps in 
access and affordability between mental health and physical healthcare 
and the need for better enforcement of this law.
  For example, studies show that insured people are nearly four times 
as likely to go out of network and pay higher fees for mental health 
care than for physical healthcare. With one in five Americans impacted 
by mental health disorders, we must do better.
  After many years of engaging on this issue and Congress passing more 
laws to strengthen parity, I was excited to see the Biden-Harris 
administration push to update the final parity rules which will allow 
for greater access to mental health and substance use disorder care.
  These regulations implemented an update in the law to close gaps and 
improve compliance with parity, which is critical for the 84.5 million 
Americans with these conditions.
  I had hoped that these rules would finally clarify and strengthen 
protections, while reducing barriers to treatment for mental health. 
These rules would have required health plans to make changes when they 
are providing inadequate access to mental health and substance use 
care.
  These rules would have made clear that plans cannot use more 
restrictive prior authorization, or other medical management 
techniques, or narrower networks to make it harder for people to access 
mental health and substance use disorder benefits than their medical 
benefits.
  These rules would also have closed loopholes and required more than 
200 additional health plans to comply with the parity law, providing 
critical protections to 120,000 consumers.
  However, in response to a recent lawsuit, the Trump administration 
released an announcement that it no longer plans to enforce the 2024 
regulations to protect individuals with mental health conditions and 
substance use disorders from discrimination in health insurance.
  Together with 17 of my colleagues, I have written to the Trump 
administration urging them to reverse course on this senseless 
decision. We shared our strong bipartisan sentiment that this decision 
``marks a dangerous step in the wrong direction.''
  We shared that it is clear that health plans are still consistently 
violating the law and systematically limiting access to mental health 
and substance use disorder care. Rather than pausing enforcement or 
reconsidering the regulations, now is the time to strengthen 
enforcement and meaningfully provide and protect our constituents from 
discrimination and improve access to care.
  There are so many more like Timothy out there right now suffering and 
in very real danger of losing access to lifesaving treatment. Instead 
of denying them that care, let's support enforcement of our mental 
health and addiction parity laws.
  For Timothy and his family and friends, the battle continues to 
achieve this.

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