Sweeping federal legislation aimed at once and for all achieving parity between physical and mental health care likely would cost tens of billions of dollars and has little chance of passing in a divided Congress.
Still, U.S. Sen. Michael Bennet said he’s bringing forward his landmark bill “as a marker, an ambition and an aspiration.”
The Colorado Democrat, who discussed the legislation Tuesday with The Colorado Sun, said he is hopeful that Congress might chip away at the massive proposal over the long term. The multipart plan would overhaul reimbursement rates for Medicare and Medicaid, forcing the government insurance programs for seniors and low-income people to increase mental health coverage.
“This is going to be a long argument, there is no doubt about it,” said Bennet, who is on the Senate Finance Committee, which oversees Medicare and Medicaid. “This is an aspiration that we should have as a country.”
A federal law passed in 2008 called for parity in private insurance, forcing insurance companies to include mental health care and substance abuse benefits that are comparable to those of other medical appointments. But the Mental Health Parity and Addiction Equity Act did not extend to Medicare and Medicaid.
“It makes me feel like the promise that we’ve made of parity with respect to mental health and traditional health care has been a false promise,” Bennet said.
In the 15 years since the act was signed, Americans have continually reported that even if their insurance plan purports to cover mental health, it’s often impossible to find a therapist who accepts the plan.
The legislation, introduced this week and called the Better Mental Health Care for Americans Act, is an attempt to address mental health care not through grants and special programs, but by rewriting the financial mechanisms that run the government insurance systems. It does not yet have a price tag, but Bennet’s staff estimated the whole package would cost in the tens of billions of dollars.
The legislation proposes that Medicare would pay higher rates to doctors’ offices and other outpatient clinics that incorporate mental health care into medical appointments. The goal is to provide seniors a “one-stop shop” for mental and physical care.
It would also require that copays for mental health care do not cost more than those for other medical care. It would give the federal Centers for Medicare and Medicaid Services the authority to examine health care plans and hold off federal payments if parity is not followed.
And the bill says that Medicare Advantage plans, which customers purchase through private companies, must provide accuracy and transparency in their directories that list therapists and doctors in the plan’s network. Customers now report that mental health professionals listed in those directories often are not taking new patients or have monthslong waiting lists.
The legislation also calls for various federal agencies, including the Substance Abuse and Mental Health Services Administration, to create plans that would improve behavioral health outcomes, and to review the evidence regarding coordinated mental and physical health care.
The measure follows a February report from the Centers for Disease Control and Prevention that found the nation’s state of mental health deteriorated during the isolation of the COVID pandemic. Among the findings: nearly 3 in 5 teenage girls felt persistently sad or hopeless in 2021.
The same week as the bill’s introduction, Bennet met with U.S. Surgeon General Vivek Murthy to discuss the “science experiment that we are running on our kids with social media.” He also talked to the CEO of Denver Health, Donna Lynne, regarding the care provided by the hospital for low-income patients that is not reimbursed by Medicaid or Medicare.
Bennet, who was superintendent of Denver Public Schools before he was appointed to the U.S. Senate in 2009, said youth suicides and the unhealthy pressures of social media have only worsened since he worked in the school district. The crisis extends from Colorado’s largest cities and to far-flung towns.
“We’ve seen an epidemic of teen suicides on the Eastern Plains,” he said. “Often, people aren’t insured in ways to get mental health care to begin with, and even if they are, it can almost be a moonscape of services.
“Then we had COVID.”