Convinced that an illness of the mind is as important as one of the lungs or heart, the state Senate yesterday passed a landmark bill that demands equal insurance coverage for mental and physical illnesses. Gov. Christine Gregoire is expected to sign the bill into law as early as next week.

The 40-9 bipartisan vote comes five weeks after the state House approved the measure and ends seven years of frustration for proponents who saw the idea rejected session after session.

The measure will eventually cost the state about $8 million a year in extra coverage for state employees and those enrolled in the state's Basic Health Plan for those with low incomes. It also will drive up the cost of health premiums for many Washington residents by 1 to 5 percent, depending on who is doing the math.

The measure was made more palatable during this session's budget crunch because it won't be fully phased in until July 2010.

It will potentially benefit about 900,000 people. The mandate does not apply to businesses with 50 or fewer employees, self-insured companies or plans purchased by individuals. Opponents argued that the measure will hurt businesses and workers, and could force some people off insurance altogether.

For Colleen McManus, 45, who has experienced depression and severe anxiety attacks for nearly 20 years, the bill cannot come soon enough.

McManus said that as a young woman, she earned a bachelor's degree, married and was teaching at an infant-care center when her life began falling apart. The condition she once attributed to a personality quirk became so acute she had trouble coping with daily life and was hospitalized. Her marriage ended.

Because her health insurance did not cover the mounting bills, social workers advised her to give up work and apply for Social Security disability benefits, said McManus, of Lake City.

That sparked a cycle in which she took part-time jobs while forgoing disability benefits. Because she could not afford proper treatment while working, her condition would worsen and she would again find herself out of a job and applying for disability.

"I felt worthless," she said. "I can't help thinking that if I had mental-health-care coverage, that maybe I could have continued supporting myself and never gone on disability. Of course, I'll never know that."

McManus said she has enjoyed her most fulfilling and stable years since landing a job as a sound technician at the Seattle Children's Theatre in 2000. The job offered good mental-health benefits through an international union.  

Unfortunately, the job ended after three years. McManus continues to work part time as a sound technician at a variety of Seattle-area theaters and receives mental-health coverage as a legacy of her former job, although that coverage will end in three months.

"I'm not out of the woods yet," McManus said. "But it seems very hopeful that if I can stick it out and patch together coverage for the next few years until the bill is fully implemented, then I can feel free to concentrate on finding work and knowing the insurance should cover the expenses to treat mental illness."

Randy Revelle, who chairs the Washington Coalition for Insurance Parity, said he is elated the measure passed the Senate. He remains disappointed similar measures were rejected by each Legislature since 1998.

"This is a real body blow to the stigma surrounding mental illness," said Revelle, a former King County executive who has struggled with bipolar disorder. "This bill has as much symbolic value as it does practical value."

An actuarial analysis prepared by Ronald Bachman of PricewaterhouseCoopers and paid for by Revelle's coalition concluded the measure would increase average premiums by 1.1 percent, or $2.93, a member, a month. Bachman estimated the final impact would be only 0.44 percent after employers took steps to minimize cost increases.

But an organization that represents the state's major health-insurance industry has a different take. Sydney Smith Zvara, the executive director of the Association of Washington Health Care Plans, said people without any mental-health coverage now can expect premium increases of 4 to 5 percent.

"It's not free and it's not near free. There's a cost that comes along," Zvara said.

"Every time premiums go up, more employers opt not to cover employees or ask employees to take on a larger share," she said. "It's better to have some, or good, coverage than no health-care coverage."

Senate Majority Leader Lisa Brown, D-Spokane, described yesterday's vote as "one of my happiest days."

Minority Leader Bill Finkbeiner, R-Kirkland, was one of nine Republicans who did not support the bill.

He said the state needs to get rid of some of its existing 47 health-care mandates — such as those covering acupuncture and massage — before mental health should be considered.

Nick Perry: 206-515-5639 or nperry@seattletimes.com Christina Siderius: 360-236-8169 or csiderius@seattletimes.com