Bill Overview
Title: To amend title XVIII of the Social Security Act to ensure adequate coverage of outpatient mental health services under the Medicare program.
Description: This bill provides for Medicare coverage of intensive outpatient services that are provided by community mental health centers, rural health clinics, or federally qualified health centers.
Sponsors: Rep. Chu, Judy [D-CA-27]
Target Audience
Population: People eligible for Medicare coverage
Estimated Size: 60000000
- The bill focuses on outpatient mental health services provided under Medicare.
- Medicare primarily covers people over the age of 65, individuals with certain disabilities, and people with End-Stage Renal Disease.
- Mental health issues affect people across all demographics, but older individuals may face unique challenges such as late-onset conditions and compounded effects of co-morbid physical illnesses.
- Federally qualified health centers and community mental health centers serve a diverse population that may not otherwise have access to intensive mental health services.
- By enhancing support for these services, the bill aims to improve the mental health and overall wellbeing for those relying on Medicare.
Reasoning
- The policy is primarily aimed at individuals who are eligible for Medicare, which generally includes those over 65 years of age and certain other groups with specific health conditions.
- It is expected to have the most significant impacts on individuals with mental health needs who are currently facing barriers to accessing intensive outpatient services.
- Since the policy involves funding for outpatient mental health services, people who already have some sort of access, though inadequate, might see improvements in their wellbeing.
- Given budget constraints, not everyone eligible might experience a significant change; those in areas with fewer mental health resources may be more severely impacted or see greater benefits.
- The distribution of impacts across people is likely to be uneven, with some experiencing high improvements (especially if they currently face major barriers) and others experiencing little to no impact.
- The overall intent is to improve mental healthcare access and reduce long-term health declines for those reliant on Medicare, thus preventing more costly inpatient treatments.
Simulated Interviews
retired teacher (rural Appalachia)
Age: 67 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- I believe this policy could really help people like me access better mental health care.
- Currently, I have to travel quite a bit for decent services.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 3 |
retired accountant (urban Texas)
Age: 72 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- I already have decent access to services, but any additional support is welcome.
- The policy is a step in the right direction.
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 | 8 | 7 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 6 |
disabled former nurse (suburban California)
Age: 58 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 3/20
Statement of Opinion:
- I have struggled to find consistent mental health care that accepts Medicare.
- This policy could be life-changing.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 3 |
| Year 5 | 8 | 3 |
| Year 10 | 7 | 3 |
| Year 20 | 5 | 2 |
retired farmer (rural Wyoming)
Age: 85 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- I'm skeptical about new policies actually making a difference out here.
- But we need more mental health support.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 4 |
freelance artist (urban New York)
Age: 35 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 7.0 years
Commonness: 2/20
Statement of Opinion:
- I appreciate any added services; they're crucial in a city like NYC where everything is hyper-competitive.
- My wellbeing depends heavily on accessible support.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
retired librarian (midwestern suburb)
Age: 69 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- Better Medicare support for mental health is a necessity, not a luxury.
- I've seen too many friends just give up on getting help.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
software developer (urban Seattle)
Age: 44 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 5/20
Statement of Opinion:
- This is huge for people like me who have specific needs and depend on Medicare.
- Tech-based mental health services could be expanded.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 9 | 4 |
| Year 20 | 8 | 3 |
retired homemaker (New England town)
Age: 78 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- Having good mental health access can help so many seniors feel less isolated.
- I hope it makes services easier to access.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
retired police officer (southern small town)
Age: 82 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- I've not seen much mental health support in my community.
- We really need this kind of policy.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 3 |
retired florist (suburban Chicago)
Age: 74 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 8.0 years
Commonness: 8/20
Statement of Opinion:
- Policies like this can really help ease the burden of seeking care.
- Mental health should always be part of the conversation.
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 | 7 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 3 |
Cost Estimates
Year 1: $1000000000 (Low: $800000000, High: $1200000000)
Year 2: $1050000000 (Low: $850000000, High: $1250000000)
Year 3: $1100000000 (Low: $900000000, High: $1300000000)
Year 5: $1200000000 (Low: $1000000000, High: $1400000000)
Year 10: $1400000000 (Low: $1200000000, High: $1600000000)
Year 100: $2500000000 (Low: $2100000000, High: $2900000000)
Key Considerations
- Accurate assessment of current versus projected service uptake under the policy.
- Coordination with state-level Medicaid programs that might already cover such services.
- Monitoring of utilization rates to prevent potential overuse or abuse of services.