WASHINGTON (The New York Times News Service) -- The House is expected to pass legislation in December that would require health insurance plans to cover mental illnesses the same way they treat physical ailments, but the initiative is hung up by a father-son dispute over just what types of disorders should be included.

Both Sen. Edward M. Kennedy, D-Mass., and his son, Rep. Patrick Kennedy, D-R.I., are the chief champions in Congress of "mental health parity" legislation.

But the senator is pushing for a bill that would allow insurers to decide for themselves what mental illnesses to cover, while his son wants the equal treatment rule to be extended to every disorder recognized by the American Psychiatric Association -- the same list of illnesses covered in health plans used by members of Congress.

"Anybody who pays their health-insurance premiums is entitled to expect their plan to be there when they get sick," said Rep.

Kennedy, "whether the disease is in their heart, their kidneys, or their brain."

For Rep. Kennedy, the issue is a personal one.

A seven-term lawmaker, Kennedy's long struggle with depression and addictions to drugs and alcohol became very public last year when he crashed his car into a security barricade on Capitol Hill and later said he was addicted to prescription medicines. He spent a month undergoing drug rehabilitation at the Mayo Clinic in Minnesota and began attending meetings of Alcoholics Anonymous.

Fellow Rep. Jim Ramstad, R-Minn., became Kennedy's AA sponsor and they later teamed up to support legislation mandating equal insurance treatment for mental health.

Kennedy, who says he is "working hard every day at my recovery," argues that everyone who has health insurance should have a similar opportunity "to manage our chronic diseases."

But many health plans currently offer different treatment for mental and physical ailments. For instance, insurers frequently cap the number of visits to mental health professionals and sometimes impose higher co-payments on that kind of treatment.

That would change under the so-called "mental health parity" legislation that passed the Senate unanimously in September and is primed for a vote in the House next month.

The bills would require group insurance plans with 50 or more members to provide equal co-payments, deductibles and caps on the length of treatment for all ailments. Neither measure would force health plans to begin covering mental disorders; rather, the legislation would require plans that do to provide equal benefits for the treatment of both mental and physical ailments.

Sen. Kennedy and Sen. Pete Domenici, R-N.M., who sponsored the Senate bill, have sought to lure support from business groups worried about a hefty pricetag. The Senate bill would let individual insurers decide what constitutes mental health services and what disorders to cover. And, unlike the House measure, the Senate bill also would allow plans to limit mental health benefits to treatment by providers within their networks.

A coalition of mental health groups, including the National Alliance for the Mentally Ill, backs the Senate's approach, with many advocates saying the measure, while not as expansive as they would like, represents the best chance to pass a broad mental-health parity law.

The bill could end "10 years of gridlock in Congress" on the issue, said Michael Fitzpatrick, executive director of NAMI, which wants the House to follow the Senate's lead.

But lawmakers in the House are so far holding firm to the Kennedy-Ramstad bill.

The Senate bill is simply "not as good," said David Wellstone, whose late father, former Sen. Paul Wellstone, D-Minn., championed mental health parity before dying in a plane crash in 2002. The Senate bill "doesn't have the patient protections that my father fought so hard for," Wellstone said.

So far, 274 lawmakers have signed up to back the House bill.

One of the cosponsors, Rep. Kirsten Gillibrand, D-N.Y., said the House approach -- covering all recognized mental illnesses -- is the best move. Gillibrand said it's common sense that a mental health parity law "should include all" mental disorders.

After the House passes its bill -- expected in December -- the two chambers will be charged with negotiating a compromise measure they can pass and send to President Bush.

Republican critics of the House bill say that it is too ambitious and warn that insurers may decide to stop offering mental-health coverage at all if they are forced to provide benefits for every disorder recognized by the APA.

But mental health advocates warn that the costs of treatment can turn off patients with substance abuse problems, depression or other illnesses.

"Many people decide not to pursue treatment because either the reimbursements are not enough or the particular conditions are not covered," said M. Dolores Cimini, who runs substance abuse programs for the State University of New York at Albany.

For instance, Cimini noted, many health plans limit substance abuse treatment to in-patient programs.

But "early intervention" with outpatient programs can help someone abusing alcohol or drugs "before it becomes serious," Cimini said.

"Substance abuse conditions, especially when caught early -- just as with mammograms and cholesterol (screenings) -- really can save so many more lives," Cimini said.

Copyright 2007 The New York Times News Service. All rights reserved.