Bill Overview
Title: Access to Mental Health Services Act
Description: This bill requires the Department of Health and Human Services (HHS), jointly with other relevant agencies, to conduct outreach about the federal requirements relating to the availability of, and limitations for, coverage of mental health and substance use disorder crisis services under private health insurance plans. HHS also must report about the coverage of such services under private insurance plans, including what services are covered, the types of providers furnishing the services, and common reimbursement approaches.
Sponsors: Rep. Sewell, Terri A. [D-AL-7]
Target Audience
Population: People with private health insurance in need of mental health and substance use disorder crisis services
Estimated Size: 50000000
- The bill pertains specifically to mental health and substance use disorder crisis services under private health insurance plans.
- Globally, mental health issues and substance use disorders are prevalent, affecting a significant portion of the world's population.
- The target population includes individuals with private health insurance who need mental health and substance use disorder crisis services.
- This legislation will primarily impact individuals in countries where private health insurance is common.
- Globally, about 1 billion people are estimated to be affected by mental disorders, according to WHO, but not all have private health insurance or are in countries with similar legal structures regarding healthcare.
Reasoning
- I considered the distribution and prevalence of individuals affected by mental health and substance use disorders with private health insurance.
- The budget limitations imply that the program will not cover the entire population. Thus, impact will vary by region and availability of services.
- The policy predominantly affects those with private insurance who currently have limited access or high out-of-pocket costs for mental health services.
- The Cantril self-anchoring striving scale is used to measure perceived wellbeing before and after the policy to provide a simulated response from varied demographic responses.
- I included a diverse range from different socioeconomic, geographic, and occupational backgrounds, including those directly impacted and others with no impact due to coverage specifics.
Simulated Interviews
Software Engineer (New York City)
Age: 29 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- I have good health insurance, but the mental health coverage is limited and doesn't cover all the therapists I could see.
- If this policy improves transparency and coverage, it would definitely make it easier to find the right provider.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Marketing Manager (Chicago)
Age: 40 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- I remember how difficult it was to find effective coverage when I needed it.
- If more services and transparency became available, it would benefit many people I know still struggling.
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 | 5 |
Public School Teacher (Cleveland)
Age: 52 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- Mental health service access is a constant struggle, with long waitlists and high costs.
- The policy might offer us more options and reduce wait times, which would be a big help.
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 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Freelance Artist (San Francisco)
Age: 34 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 6/20
Statement of Opinion:
- My coverage is pretty basic and doesn't handle mental health costs well.
- Any improvement in transparency and coverage would lift a weight off my shoulders.
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 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
Construction Worker (Houston)
Age: 45 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 9/20
Statement of Opinion:
- I've not used many mental health services, but I've heard from colleagues that coverage is lacking.
- An improvement in coverage could be life-changing for those who need it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
Graduate Student (Miami)
Age: 23 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 4.0 years
Commonness: 7/20
Statement of Opinion:
- Getting in-network mental health services has been a challenge while balancing school.
- This policy could really help students and young adults like me.
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 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Retired Engineer (Boston)
Age: 67 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 4/20
Statement of Opinion:
- Mental health services were limited when I was working, but it's better now under Medicare.
- I doubt this policy will change much for retirees like me. It seems geared toward working-age folks.
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 |
Entrepreneur (Los Angeles)
Age: 37 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 6/20
Statement of Opinion:
- Insurance hasn't been very helpful when I needed therapy quickly.
- If this policy increases transparency for coverage, it will save me time and money.
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 | 7 | 7 |
| Year 20 | 7 | 7 |
Mechanic (Phoenix)
Age: 50 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 6.0 years
Commonness: 8/20
Statement of Opinion:
- I don't really use these services myself, but my brother's experience with getting covered has been rough.
- Anything that makes it easier to get services covered would be great for him.
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 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Data Analyst (Seattle)
Age: 31 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- I have not needed much mental health care myself, but seeing what my mom goes through to get services covered has been eye-opening.
- I hope this policy really increases access and options.
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 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Cost Estimates
Year 1: $15000000 (Low: $10000000, High: $20000000)
Year 2: $14000000 (Low: $9000000, High: $19000000)
Year 3: $14000000 (Low: $9000000, High: $19000000)
Year 5: $13000000 (Low: $8000000, High: $18000000)
Year 10: $13000000 (Low: $8000000, High: $18000000)
Year 100: $13000000 (Low: $8000000, High: $18000000)
Key Considerations
- Understanding the nuances of private health insurance coverage for mental health services is vital.
- Coordination between federal agencies is necessary to ensure a unified and effective outreach program.
- The potential for long-term benefits through better mental health crisis service utilization must be weighed against initial costs.