After 12-Year Quest, Domenici's Mental-Health Bill Succeeds
SARAH LUECK - Wall Street Journal


WASHINGTON -- In April 1996, Sen. Pete Domenici stood on the floor of the Senate and told colleagues "now is the time" to pass legislation requiring insurance companies to cover mental illnesses just like other medical conditions.

More than 12 years and numerous setbacks later, that legislation is finally becoming law, tucked into the administration's $700 billion rescue package.


Pete Domenici

This success marks the end of an odyssey for Mr. Domenici, for whom the bill is named. It is also an insight into how the business of politics can be intensely personal.

The New Mexico Republican started his quest after his daughter Clare, one of his eight children, was diagnosed with schizophrenia. After 35 years in the Senate, Mr. Domenici, 76 years old, is retiring after being diagnosed with an incurable, degenerative brain disease.

Mr. Domenici's original partner in the mental-health effort, Sen. Paul Wellstone of Minnesota, died in a plane crash in 2002. Sen. Edward Kennedy of Massachusetts, the Democrat who took up the cause after Mr. Wellstone's death, is battling brain cancer and wasn't in the Senate for the final vote on the bill.

"Happy is not quite the right word," Mr. Domenici said Thursday as it appeared the legislation would become law. "I'm glad that we're finished, but it's been such a long ordeal."

In the 1980s, Mr. Domenici began spending time with other parents of people with mental illness. He heard stories of financial ruin that resulted from a lack of insurance coverage. Though they were better off, Mr. Domenici and his wife Nancy "had to pay a lot of money" for their daughter's care, Mr. Domenici remembers. At some points, the Medicaid health program for the poor covered Clare's care as an adult, he says.

Mr. Domenici's memory sometimes fails him now. But he recalls a speech from 1996, when he sought to attach the measure to a health-insurance bill. "You could feel the Senate just throbbing when I was down there giving a speech, about a great country being so far off on mental illness that it's pathetic...like we had no brains," Mr. Domenici said.

Mr. Domenici and Mr. Wellstone won that Senate vote in 1996. But their provision dropped out of the legislation after negotiations with the House, with opposition from insurance companies and their allies in Congress blocking the effort. The two men squeezed a pared-down version into a spending bill later that year that "dramatically reduced our expectations and our hopes," Mr. Domenici said at the time.

The fight stalled for years largely because of opposition from Republicans who controlled the House.

In 2002, after Messrs. Domenici and Wellstone reintroduced their legislation, President George W. Bush came to Albuquerque and endorsed the concept in a speech. In a private conversation, Mr. Bush told Mr. Domenici, "You don't have to talk me into the fact that mental illness is a disease like any other sickness," Mr. Domenici and the White House say.

In October 2002, Mr. Wellstone was killed in a plane crash.

Mr. Domenici asked Sen. Kennedy to replace Mr. Wellstone as the bill's co-sponsor. Rep. Patrick Kennedy (D., R.I.), Sen. Kennedy's son, had proposed similar legislation in the House, along with other Democrats and Republicans, including Rep. Jim Ramstad of Minnesota.

From 2004 until 2006, the lawmakers negotiated with health insurers and industry groups that had successfully blocked the legislation before. The talks took place usually in a conference room in Mr. Domenici's office that has scenes of New Mexico hanging on the walls.

The New Mexico senator, sometimes bearing chocolates, would stop by regularly to prod the group toward agreement.

"How we doing? We got a deal yet?" he would say, remembers his aide Edward Hild. By early 2007, all sides found a compromise they could support.

That didn't assure swift passage in the Senate, where individual senators can stall and block bills. Mr. Domenici worked on the Republican side to smooth objections. Sen. Jim DeMint (R., S.C.) told Mr. Domenici he wouldn't agree to allow the bill to proceed without reading it first. He took a weekend and did so.

The bill passed the Senate in September 2007.

In March 2008, the House passed its own bill, but it contained provisions the health-insurance industry opposed. In June the two chambers argued over whether and how to pay for the roughly $3 billion cost of the legislation.

Mr. Domenici fretted over what he called a "fragile" compromise. If the legislation wasn't done before he retired, he worried no one would be around to push it.

"Kennedy keeps telling me, 'Domenici, it doesn't matter what you've done here, all these budgets and balanced budgets. This is the best thing you've ever done,' " Mr. Domenici said in an interview last summer.

Two weeks ago, the effort was on the rocks, stuck in tax legislation that was locked in a standoff between the Senate and House. Mr. Domenici, walking through the Capitol, seemed resigned: "Either it happens or it doesn't. I've done the best I could," he said. "This is a tough one that should have been easy."

Then: a final reprieve. After the House failed to pass the Bush administration's financial-rescue plan, the Senate decided to sweeten it with the troubled tax bill, including the mental-health measure.

Mr. Domenici called the office of Mr. Ramstad, one of the many House Republicans who had voted against the rescue bill, in the hopes he could convince him to switch.

"My secretary got a hold of him and said, 'Domenici wants to talk to you,' " Mr. Domenici said. Mr. Ramstad responded: "If the senator wants to talk to me about the bill, he doesn't have to. I'm voting for it."

Mr. Domenici said it is hard to believe his Senate career is over. He said his illness, which affects the frontal lobe of his brain, hasn't caused the rapid deterioration doctors warned him about. He is thinking of working when he goes back to New Mexico, at his son's law firm. His wife "knows I better find something to do."

Mr. Wellstone's son David visited Mr. Domenici recently. The mental-health bill is named after both men. "He hugged me and said how glad he was I was involved in this, how proud he was to have his father's name next to mine."