Bill Overview
Title: Mental Health Transparency Act
Description: This bill requires private health insurance plans to publish information about the number and percentage of behavioral health care and substance use disorder treatment providers located in the service area of the plan that are in-network. Additionally, the Department of Health and Human Services must establish designations to reflect the breadth of in-network coverage for each type of provider in a service area.
Sponsors: Rep. Horsford, Steven [D-NV-4]
Target Audience
Population: Individuals relying on private insurance for mental health and substance use treatment
Estimated Size: 218000000
- The bill will affect people who have private health insurance plans as it requires these plans to publish data on behavioral health and substance use disorder providers.
- Individuals seeking mental health care from in-network providers will have better access to information, impacting their decision-making process.
- Substance use disorder treatment users under private insurance plans will also be impacted due to increased transparency.
- Healthcare providers, especially those offering mental health and substance use disorder services, may be indirectly impacted, as transparency could influence network participation.
- Stakeholders including private health insurance companies and the Department of Health and Human Services will be involved in the implementation of this legislation.
Reasoning
- This policy impacts individuals who have private health insurance that covers mental health and substance use disorder treatments. This is roughly about 218 million Americans. However, not all of these individuals will be actively seeking treatment or benefit directly from increased transparency.
- The target group likely includes mentally and behaviorally challenged individuals who might struggle to find in-network providers currently due to lack of information. It could potentially improve their well-being by making care more affordable and accessible.
- Given that mental health services might be underutilized currently due to barriers like reimbursement issues and availability of providers, this policy could lead to higher utilization of such services.
- Certain segments, like young adults and middle-aged individuals who are more likely to face mental health challenges, may see more pronounced impacts. Parents dealing with children’s mental health issues might also benefit.
- The cost limitations suggest that not every private insurance plan might adopt changes immediately, which could limit initial policy impact and require focusing efforts in high-need areas.
Simulated Interviews
software engineer (San Francisco, CA)
Age: 35 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 15/20
Statement of Opinion:
- I'm glad that this policy is being implemented. It has been really challenging to find a therapist that is both in-network and qualified for my needs. This bill could make it easier for me to access the care I need without straining my finances.
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 | 8 | 5 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
insurance broker (Houston, TX)
Age: 42 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 12/20
Statement of Opinion:
- This should have been in place a long time ago. I always found it frustrating not knowing which providers were in-network. It's already stressful enough dealing with my own and my parent's health issues without insurer hurdles.
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 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 5 | 3 |
teacher (Chicago, IL)
Age: 50 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 2.0 years
Commonness: 10/20
Statement of Opinion:
- I'm hopeful but skeptical. Transparency is good, but it has to actually make treatments more accessible. If it doesn't lead to better availability of affordable treatment, then it's just window dressing.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 6 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
bartender (New York, NY)
Age: 29 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 4.0 years
Commonness: 16/20
Statement of Opinion:
- Having updated information on which mental health providers are available in my plan would definitely help. Finding someone suitable is difficult when every visit's cost is uncertain.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 3 |
| Year 5 | 7 | 3 |
| Year 10 | 6 | 2 |
| Year 20 | 5 | 2 |
retired (Phoenix, AZ)
Age: 68 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 2.0 years
Commonness: 8/20
Statement of Opinion:
- I appreciate that insurance companies will have to be clear on which doctors I can see. But for older people like me who might not easily access digital information, I hope they also provide other means to get this data.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 4 | 3 |
| Year 20 | 4 | 3 |
student (Seattle, WA)
Age: 23 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 6.0 years
Commonness: 14/20
Statement of Opinion:
- I often find myself without the support needed because it takes weeks just to find a therapist with my insurance. If this bill means that process is easier, it will be a lot less stressful for students like me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 5 |
| Year 5 | 9 | 5 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 3 |
nurse (Miami, FL)
Age: 59 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 11/20
Statement of Opinion:
- This transparency should help not only my family but also patients I encounter professionally. But I have doubts if there will be enough available practitioners listed who will actually take insurance.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 9 | 7 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
homemaker (Denver, CO)
Age: 45 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 7.0 years
Commonness: 13/20
Statement of Opinion:
- It's often impossible getting timely appointments when half the time I can't confirm if counselors are covered by our insurance. Making provider information available could change everything for families like mine.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 3 |
IT consultant (Atlanta, GA)
Age: 36 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 4.0 years
Commonness: 15/20
Statement of Opinion:
- It might help me budget better around my health expenses. If my insurer lists all available psychologists, booking appointments should become less of a financial guessing game.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 3 |
writer (Boston, MA)
Age: 40 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- I have faced difficulties finding a suitable therapist. The idea of not having to guess if someone is in-network would ease mental strain considerably.
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 | 8 | 4 |
| Year 20 | 7 | 4 |
Cost Estimates
Year 1: $50000000 (Low: $30000000, High: $70000000)
Year 2: $45000000 (Low: $27000000, High: $63000000)
Year 3: $40000000 (Low: $24000000, High: $56000000)
Year 5: $35000000 (Low: $21000000, High: $49000000)
Year 10: $30000000 (Low: $18000000, High: $42000000)
Year 100: $25000000 (Low: $15000000, High: $35000000)
Key Considerations
- Implementation timeline and costs for insurance companies to adjust systems.
- Potential for improved healthcare outcomes through better access to provider data.
- Monitoring and compliance costs for private insurers and the government.
- Uncertain behavioral changes by healthcare consumers based on transparency.