WASHINGTON - Time is running out for U.S. Rep. Jim Ramstad and his hope of enacting mental health legislation on which he has staked his political legacy.

For the past 12 years, the nine-term Minnesota Republican has fought for legislation that would require health insurers to cover mental health in the same way they do physical ailments. But with little more than a week left until Congress breaks for election season, it could be now or never for the soon-to-retire Ramstad.

"It'd be devastating [if the legislation doesn't pass]," Ramstad said Wednesday. "We simply cannot afford to miss this window of opportunity."

After many contentious months of negotiation, both chambers of Congress have agreed to terms of a bill, which has been attached in the Senate to a bigger, must-pass tax package needed to keep the government running. That bill could reach the Senate floor as early as today, while the House wouldn't vote until early next week.

Named for Wellstone

The mental health legislation, named after the late Sen. Paul Wellstone, who championed the cause before his death in 2002, involves a key compromise. It allows individual health insurers to decide what conditions to cover, rather than using the Diagnostic and Statistical Manual of Mental Disorders, the standard reference work for psychologists and psychiatrists. That's a big change from the original House bill, which was supported by the Wellstone forces.

But the agreement still mandates that all co-payments, deductibles and annual and lifetime caps on mental health benefits be the same as those for medical and surgical benefits, and that it also extends out-of-network coverage for mental health disorders.

Despite the changes, David Wellstone, the senator's son, said the bill is something he is proud to have his father's name attached to.

"It's a pretty solid bill that keeps most of the stuff we were pushing hard for," he said. "Absolutely, I'm still proud of this bill."

Opponents of the bill, including a coalition of employers and insurers lobbying against it, have said it would mandate expensive new treatments and drive up costs in a year when health care entitlement programs, such as Medicaid and Medicare, faced cuts.

A report by the nonpartisan Congressional Budget Office estimated that the original House bill -- which is slightly more expensive than the compromise version -- would cost the private sector $1.3 billion in 2008 alone and increase from there.

But Ramstad notes that would only amount to a two-tenths of a percent increase in premiums. "We're so sure of that, that if premiums were to increase by 1 percent or more, the plans could opt out of the parity requirements, so it wouldn't apply," he said.

A personal connection

For both Ramstad and the bill's lead sponsor, Rep. Patrick Kennedy, D-R.I., the issues of mental health and chemical dependency are personal. Both have struggled with alcoholism; Kennedy even asked Ramstad to be his sponsor throughout his recovery process after a high-profile car crash on Capitol Hill.

"One of the reasons why I'm so passionate about this issue is that I know recovery works," Kennedy said at a rally Wednesday.

"Treatment should not be accessible only to members of Congress, but should be accessible to every single American."

A couple of hurdles remain for the measure. The first is for the Senate to sign off on the underlying tax legislation to which it is attached. Then the measure must clear the House. Ramstad remains confident his signature bill, and possibly the final piece of his political legacy, will go through.

"We're on the verge of passing the bill, all the interested parties are there," he said. "Now it's up to the 535 members of the House and Senate, and the president as well."

Mitch Anderson • 202-408-2723