CAPITOL HILL Mental health bill draws mixed support

Many behavioral health advocates say a pending House bill to reform the nation’s mental healthcare system is a step in the right direction, but isn’t as strong as it could be.

“I’m concerned that as it gets marketed around the House and across the country, it’s getting oversold,” said U.S. Rep. Joe Kennedy III, D-Mass., who helped pass the bill out of committee. “It does some good things, but it isn’t anything near the reforms that are necessary.”

Kennedy sits on the House Energy & Commerce Committee, which approved the “Helping Families in Mental Health Crisis Act” on June 15. The proposal is expected to come up for a vote in the full House in early July.

National Alliance on Mental Illness CEO Mary Gilberti, in a statement, applauded passage of the bill from committee as a “step in the right direction as we begin to address the many gaps in America’s mental health system.”

“Today, one in five Americans have a mental health condition,” she said. “With the right help, people can live well and thrive, but at least half of people with mental illness do not get the care they need.”

The bill would enhance crisis response services, provide grants to track inpatient and residential treatment beds, promote early intervention and support the integration of mental health, substance abuse and primary medical care.

“Delivering evidence-based treatment is how we will finally conquer stigma surrounding mental illness, and this bipartisan bill transforms the federal government’s approach to mental health,” U.S. Rep. Tim Murphy, R-Pa., the bill’s main sponsor and a clinical psychologist, said in a statement. “This bill calls for a complete overhaul of the current federal system, refocusing resources on helping those with the most serious mental illnesses by getting them treatment before, during and after a psychiatric crisis.”

He and other advocates, though, have called for adding funding into the proposal.

The version of the bill that emerged from the committee with bipartisan support was stripped of many of its original provisions, including billions of dollars in Medicaid funding for mental health services.

Kennedy said a drastic overhaul of the Medicaid reimbursement system is desperately needed. In many cases, he said, Medicaid reimbursements to providers are so low that some mental health clinicians effectively treat Medicaid patients for free.

Without an incentive to treat those patients, many providers instead opt not to accept patients with Medicaid, limiting access to mental health services.

A Kennedy-sponsored amendment to essentially lift a restriction that prevents children from simultaneously receiving mental and physical health treatment through Medicaid is included in the bill.

The Brookline Democrat also said he also wished the bill would strengthen parity regulations, which are intended to require insurance companies to cover mental illness and addiction the same way they would cover a physical illness, such as cancer.

National Alliance on Mental Illness surveys show insurance companies deny authorization for mental health care at more than double the double the rate they deny authorization for general medical care.

While he said he realizes the cost associated with a comprehensive overhaul is significant, Kennedy said society is already paying the cost “in our criminal justice system, in our homeless programs, in our veterans programs and in our emergency department visits.”

“It’s a horrible system that fails patients, their families and communities every day,” Kennedy said.

Despite his concerns that the bill got watered down, Kennedy still voted for it in committee and plans to vote for it on the House floor barring any major alterations.

“Something is better than nothing,” he said. “But, yeah, I’m concerned if the bill is marketed as an overall systemic fix to the system, then people are going to say, ‘We just did that, so we’re not going to do it again.’ But we didn’t just do it. We did a small, little mental health bill that has some good things in it … It is essentially a step forward, but I think it’s a half-step forward.”