Bill Overview
Title: Strengthen Kids’ Mental Health Now Act of 2022
Description: This bill establishes several requirements to support the provision of behavioral health services under Medicaid and other programs, particularly for children. For example, the bill temporarily requires payment for pediatric mental, emotional, and behavioral health services under Medicaid to align with Medicare payments to providers. The bill provides for a 100% Federal Medical Assistance Percentage (i.e., federal matching rate) for any associated additional expenditures. The Centers for Medicare & Medicaid Services must issue guidance on how state Medicaid programs may expand the availability of telehealth services and mental, emotional, and behavioral health services. In addition, the Health Resources and Services Administration must award grants to support (1) pediatric behavioral health care integration in communities, (2) pediatric mental health and substance use disorder workforce training, and (3) the infrastructure of pediatric hospitals and rural health clinics with respect to behavioral health services.
Sponsors: Rep. Eshoo, Anna G. [D-CA-18]
Target Audience
Population: Children needing mental, emotional, and behavioral health services worldwide
Estimated Size: 30000000
- The bill focuses on pediatric mental health, impacting children and adolescents.
- Medicaid covers about 30 million low-income children in the U.S.
- CMS promotion of telehealth services and mental health services expansion will potentially reach children nationwide using Medicaid.
- Eligible children on Medicaid will have enhanced access to mental health services, impacting their wellbeing.
Reasoning
- This policy targets pediatric mental health services for the approximately 30 million children on Medicaid in the U.S. It aims to improve access to mental health services which may involve telehealth, making services more widely available even in rural areas.
- The policy potentially impacts children, families, and mental health service providers. Its emphasis on telehealth can particularly benefit those in rural settings or those with limited access to healthcare facilities.
- Not every child on Medicaid will have mental health needs, so the impact will range from none to high depending on individual circumstances.
- Budget constraints may affect the reach and quality of services provided, which emphasizes the necessity to identify and prioritize those most in need.
Simulated Interviews
student (rural Virginia)
Age: 8 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- I sometimes feel sad and don't have anyone to talk to where I live.
- Mom says we'll be able to talk to a special doctor on a computer screen soon which is really cool.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 9 | 5 |
| Year 10 | 9 | 5 |
| Year 20 | 8 | 4 |
high school student (urban California)
Age: 15 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 4/20
Statement of Opinion:
- It's sometimes hard for me to focus, but more resources to help with my ADHD would be great.
- I hope this makes it easier to see the therapist I like without waiting too long.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 5 |
student (suburban Texas)
Age: 9 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- I've been having trouble going to school because I feel so scared.
- My mom says help might be easier to get soon, and I hope it helps me not feel so anxious.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 9 | 4 |
| Year 20 | 8 | 3 |
student (urban New York)
Age: 10 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 3/20
Statement of Opinion:
- I don't really have any issues, so I'm not sure what this means for me.
- I think it's good for others I know who might need it more.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 7 | 7 |
student (rural Idaho)
Age: 12 | Gender: other
Wellbeing Before Policy: 3
Duration of Impact: 10.0 years
Commonness: 2/20
Statement of Opinion:
- Being who I am here is tough, and talking it through with someone could help.
- The idea of eventually getting support through my computer is pretty cool.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 6 | 3 |
| Year 3 | 7 | 3 |
| Year 5 | 8 | 3 |
| Year 10 | 8 | 3 |
| Year 20 | 8 | 2 |
student (suburban Illinois)
Age: 13 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 7.0 years
Commonness: 4/20
Statement of Opinion:
- Being bullied at school has really affected me, and I hope this policy helps me feel better.
- Talking to someone more regularly would be awesome.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 4 |
student (rural Kentucky)
Age: 11 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- It's tough sometimes because people don't understand me.
- If this helps me talk better and feel better, I'd be really happy.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 8 | 3 |
high school student (urban Michigan)
Age: 17 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 5/20
Statement of Opinion:
- I do get stressed about exams and the future, so more support options will possibly be helpful for focus and confidence.
- It'd be great not to worry about access if I need it in a hurry.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 7 | 6 |
student (southern Florida)
Age: 6 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 4/20
Statement of Opinion:
- I sometimes don't understand grown-ups because they talk funny; I think talking to someone who knows could help.
- My grandma says I might see a doctor on the screen to help me understand better.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 4 |
middle school student (urban New Jersey)
Age: 14 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 7.0 years
Commonness: 4/20
Statement of Opinion:
- I struggle with feeling down, and I think seeing someone through my phone would be a lot easier.
- Knowing more options might be there helps me see a way to manage things.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 3 |
Cost Estimates
Year 1: $2000000000 (Low: $1800000000, High: $2200000000)
Year 2: $2100000000 (Low: $1890000000, High: $2310000000)
Year 3: $2200000000 (Low: $1980000000, High: $2420000000)
Year 5: $2400000000 (Low: $2160000000, High: $2640000000)
Year 10: $3000000000 (Low: $2700000000, High: $3300000000)
Year 100: $10000000000 (Low: $9000000000, High: $11000000000)
Key Considerations
- Alignment of Medicaid payments to Medicare levels will significantly increase federal costs.
- Full federal funding of additional expenses removes financial burdens from states, incentivizing states to adopt measures quickly.
- The expansion of telehealth services offers broad reach but could contribute to higher overall service usage and costs.
- The grants target systemic improvements with long-term cost-savings potential but involve upfront expenses.