Bill Overview
Title: Closing Health Coverage Gaps for Public Servants Act
Description: This bill eliminates the ability for nonfederal governmental group health plans to opt out of certain coverage requirements, such as parity in providing benefits for mental health and substance use disorder benefits.
Sponsors: Sen. Murphy, Christopher [D-CT]
Target Audience
Population: Individuals employed by nonfederal government entities receiving group health coverage
Estimated Size: 10000000
- The bill targets nonfederal governmental group health plans, which include state, municipal, and local government employment coverage.
- This legislation impacts individuals employed at nonfederal government positions who receive insurance from governmental group health plans.
- Health plan members impacted are a mix of active employees and their dependents, potentially impacting thousands per governmental jurisdiction.
- Coverage requirements often address a significant gap in healthcare related to mental health and substance use disorders.
Reasoning
- The bill primarily impacts individuals employed by state and local governments who are part of group health plans that currently opt out of certain mental health and substance use disorder benefits. This population is estimated to be about 10 million people.
- Individuals employed in these government positions may vary significantly in their financial stability and access to other forms of healthcare, leading to varying levels of impact.
- The policy is constrained by a significant budget, suggesting substantial resources will be allocated to improving the designated areas of healthcare coverage.
- Considering a mix of different perspectives and jobs is crucial to understanding both potential financial and social impacts, with particular attention to individuals who have reliant family members or personal needs for mental health care.
Simulated Interviews
Teacher (Austin, TX)
Age: 34 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 15/20
Statement of Opinion:
- I often worry about the lack of mental health services included in our family health plan.
- If these plans covered mental health better, it would reduce stress significantly.
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 | 9 | 6 |
| Year 20 | 9 | 6 |
Police Officer (Madison, WI)
Age: 45 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 10/20
Statement of Opinion:
- Our current health plan barely covers the therapy I need.
- Better mental health coverage could help me be a better parent and worker.
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 | 9 | 5 |
| Year 20 | 9 | 5 |
Municipal Transport Planner (Portland, OR)
Age: 29 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 15.0 years
Commonness: 8/20
Statement of Opinion:
- I've considered paying out of pocket for mental health support, but it's not affordable on my current plan.
- Full coverage would help my partner and I maintain a healthy life balance.
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 | 9 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 8 |
City Maintenance Worker (Philadelphia, PA)
Age: 52 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 6/20
Statement of Opinion:
- I can't currently obtain the mental health care I need, due to coverage gaps.
- Improved coverage would really take a burden off my shoulders.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 9 | 5 |
| Year 20 | 9 | 5 |
State Policy Analyst (Denver, CO)
Age: 60 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- I've seen firsthand the stress that gaps in coverage cause other families.
- Personally, this change wouldn't affect me much, but it's crucial for those who need mental health support.
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 |
Social Worker (Nashville, TN)
Age: 38 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 10/20
Statement of Opinion:
- My job shows me the effect of untreated mental health problems every day.
- Enhanced health coverage will ease the burden on my clients and myself.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 7 |
Firefighter (Columbus, OH)
Age: 50 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 12/20
Statement of Opinion:
- We currently have to budget carefully for our mental healthcare needs.
- Any increase in coverage would make a significant difference to us.
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 | 9 | 6 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 7 |
Public Librarian (Sacramento, CA)
Age: 42 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- I see many people struggling with the lack of mental health resources.
- I personally think this policy change is overdue and essential for community health.
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 | 8 |
Retired Civil Engineer (Miami, FL)
Age: 61 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 14/20
Statement of Opinion:
- I am nearing retirement, so this may not affect me directly.
- However, it's crucial to set the ground for the next generation to have better healthcare options.
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 |
City Planner (Seattle, WA)
Age: 31 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 9/20
Statement of Opinion:
- The gaps in mental health coverage have been a challenge as my partner transitions between jobs.
- This policy would relieve a lot of financial pressure on us.
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 | 9 | 6 |
| Year 20 | 9 | 7 |
Cost Estimates
Year 1: $2000000000 (Low: $1500000000, High: $2500000000)
Year 2: $2100000000 (Low: $1600000000, High: $2600000000)
Year 3: $2200000000 (Low: $1700000000, High: $2700000000)
Year 5: $2400000000 (Low: $1800000000, High: $2900000000)
Year 10: $2800000000 (Low: $2200000000, High: $3400000000)
Year 100: $3400000000 (Low: $2500000000, High: $3800000000)
Key Considerations
- The policy requires absorbing additional costs into state and local budgets, potentially necessitating reallocations or increased contributions.
- There is potential for long-term savings through improved health outcomes and reduced acute care experiences.
- The policy may drive administrative innovation and cost efficiency within government health plans.
- Short-term financial impacts could lead to demands for increased federal assistance or grants during transitional phases.