Bill Overview
Title: REMOVE Copays Act
Description: This bill prohibits the Department of Veterans Affairs from imposing or collecting any co-payment for a veteran's first three mental health outpatient care visits in a calendar year. However, such prohibition must not apply with respect to the imposition or collection of copayments for medications.
Sponsors: Rep. Takano, Mark [D-CA-41]
Target Audience
Population: Veterans enrolled in the VA health care system seeking mental health outpatient care
Estimated Size: 9200000
- The bill specifically targets veterans enrolled in the VA health care system, focusing on mental health outpatient care.
- There are approximately 18 million veterans in the United States, but not all are enrolled in the VA health care system.
- As of recent data, about 9.2 million veterans are enrolled in the VA health care system.
- Out of these, a significant portion seek mental health services, although the exact number varies.
- The bill affects any veteran within this system seeking mental health care, specifically those who would have paid copays.
Reasoning
- A significant number of veterans are enrolled in the VA system, and the bill specifically targets those seeking mental health services. However, not all of those veterans will require mental health services, nor will they all be impacted by the elimination of copays as some may not have financial constraints.
- The budget limit implies that the bill should be efficiently allocated to serve the veterans who require three or fewer mental health visits, potentially at an average co-pay cost of around $100-200 per visit.
- The policy will likely benefit those with limited financial resources more significantly, increasing their access to mental health services.
- There will be diversity in the impact among veterans due to varying geographic distributions, specific mental health needs, and different financial situations.
Simulated Interviews
Veteran - Student (San Antonio, TX)
Age: 28 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 12/20
Statement of Opinion:
- I just got out of the service and being a student has its own stress.
- I've been struggling to keep up with my classes due to depression.
- This policy will help me save some money to afford my textbooks.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Veteran - Part-time Retail Worker (Charleston, SC)
Age: 45 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- Paying for therapy is a bit tough on a part-time salary.
- Every bit helps, especially when I need to take care of my kids.
- It's a blessing to have the first few visits covered.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 7 |
| Year 5 | 9 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Retired Veteran (Dayton, OH)
Age: 62 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 2.0 years
Commonness: 14/20
Statement of Opinion:
- I've been saving for my grandson’s college fund.
- With fixed income, even small co-pays add up.
- Having the first visits free is relief and helps me maintain my health.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
Veteran - Nurse (Denver, CO)
Age: 31 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 3.0 years
Commonness: 11/20
Statement of Opinion:
- I just started working again, and this really helps in not worrying about initial costs.
- With a baby, expenses are everywhere.
- It's great that I can focus more on getting better rather than how much it's going to cost.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 6 | 6 |
Veteran - IT Consultant (Miami, FL)
Age: 53 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 8/20
Statement of Opinion:
- Although I use private healthcare, it's good to see these kinds of changes in VA policies.
- I may not need it, but I know some friends who would benefit.
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 | 8 | 8 |
Veteran - Community Organizer (Seattle, WA)
Age: 39 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 9/20
Statement of Opinion:
- Mental health is so important, and reducing these costs is a step in the right direction.
- I can now avoid the financial strain of therapy while continuing my community work.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Veteran - Mechanic (Phoenix, AZ)
Age: 46 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 1.0 years
Commonness: 7/20
Statement of Opinion:
- While nice, it's not something that changes my day-to-day.
- I've got good insurance that already helps me manage these costs.
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 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
Retired Veteran (Huntsville, AL)
Age: 58 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 13/20
Statement of Opinion:
- Keeping up with my mental health without worrying about co-pay is great.
- It eases a bit of the financial burden on me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 7 |
| Year 20 | 7 | 7 |
Veteran - Volunteer (Portland, OR)
Age: 72 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 1.0 years
Commonness: 8/20
Statement of Opinion:
- This policy seems to help younger veterans more.
- However, it's good that mental health is being prioritized.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
Veteran - Policy Analyst (Washington, DC)
Age: 37 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 10/20
Statement of Opinion:
- Any reduction in cost helps me justify regular visits.
- I believe these support mechanisms can lead to better mental health outcomes.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Cost Estimates
Year 1: $276000000 (Low: $165600000, High: $276000000)
Year 2: $276000000 (Low: $165600000, High: $276000000)
Year 3: $276000000 (Low: $165600000, High: $276000000)
Year 5: $276000000 (Low: $165600000, High: $276000000)
Year 10: $276000000 (Low: $165600000, High: $276000000)
Year 100: $276000000 (Low: $165600000, High: $276000000)
Key Considerations
- The estimated number of veterans utilizing the mental health copayment waiver may vary due to utilization rates and outreach efforts.
- Long-term potential cost offsets through improved mental health outcomes are challenging to quantify and remain speculative.
- This policy supports broader mental health and veteran care objectives, aligning with national priorities.