Bill Overview
Title: MENTAL Health for Kids and Underserved Act
Description: This bill requires the Centers for Medicare & Medicaid Services (CMS) to issues guidance on how states may provide behavioral health services via telehealth under Medicaid and the Children's Health Insurance Program (CHIP), including for high-risk individuals and children. The CMS must also report on the impact of such telehealth services on the access, cost, and quality of behavioral health services under Medicaid and CHIP.
Sponsors: Sen. Thune, John [R-SD]
Target Audience
Population: Medicaid and CHIP beneficiaries needing behavioral health services
Estimated Size: 87000000
- The bill focuses on providing behavioral health services through telehealth under Medicaid and CHIP, which implies the primary target population is Medicaid and CHIP beneficiaries.
- Medicaid and CHIP serve low-income individuals; therefore, eligible low-income children and individuals will be the primary focus.
- Telehealth services aim to enhance access to health care for individuals who may have geographic, transportation, or other barriers.
- Given the focus on children and high-risk individuals, these groups will be particularly impacted.
- Behavioral health services cover mental health and substance use disorders, impacting individuals needing these specific healthcare services.
Reasoning
- The MENTAL Health for Kids and Underserved Act will likely benefit children and underserved communities by increasing access to behavioral health services, particularly for those facing geographical or transportation barriers.
- The budget constraints limit the number of people who can be served initially but should provide significant enhancements to service access and quality for those served.
- The focus on telehealth will likely improve access for rural populations, those without immediate access to specialized services, and individuals with transportation limitations.
- The impact will vary between individuals with high need and more occasional users of behavioral health services.
- The Cantril wellbeing scores help assess the subjective improvement in perceived quality of life and wellbeing of individuals benefiting from the policy.
Simulated Interviews
student (rural Nevada)
Age: 10 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 14/20
Statement of Opinion:
- Virtual therapy sessions through telehealth have made it easier for my child to get help without traveling long distances.
- This policy should be permanent because it makes therapy more accessible.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
single mother (urban Ohio)
Age: 35 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 8.0 years
Commonness: 12/20
Statement of Opinion:
- It's easier to manage my anxiety and get support through telehealth while managing the kids at home.
- The continuation of these services is crucial for my family's mental health.
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 | 6 |
| Year 20 | 9 | 7 |
high school student (suburban Texas)
Age: 17 | Gender: other
Wellbeing Before Policy: 3
Duration of Impact: 5.0 years
Commonness: 13/20
Statement of Opinion:
- Teletherapy has given me a chance to talk to someone regularly.
- It's not as good as seeing someone in person, but it's better than nothing.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
forestry worker (rural Kentucky)
Age: 45 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- Accessing therapy has always been a challenge. Telehealth makes it possible without losing a day's work.
- I hope the telehealth services continue under Medicaid.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
freelancer (urban New York)
Age: 30 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 8.0 years
Commonness: 15/20
Statement of Opinion:
- Telehealth makes my therapy sessions more flexible around my work schedule.
- I strongly support the continuation of telehealth services.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 7 |
unemployed (urban California)
Age: 50 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 6.0 years
Commonness: 9/20
Statement of Opinion:
- Access to regular check-ins via telehealth has been beneficial.
- It's important for sustaining my recovery journey.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 6 |
student (suburban Florida)
Age: 8 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 12.0 years
Commonness: 18/20
Statement of Opinion:
- With the help of telehealth, my child's therapist is more accessible.
- It greatly supports her ongoing development.
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 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 7 |
teacher (rural Alabama)
Age: 27 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 7.0 years
Commonness: 11/20
Statement of Opinion:
- Teletherapy sessions have been easier to schedule with a new baby.
- It helps balance my mental health needs with family.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 7 | 5 |
| Year 20 | 8 | 6 |
IT consultant (urban Illinois)
Age: 42 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 9.0 years
Commonness: 8/20
Statement of Opinion:
- Telehealth bridges gaps when in-person sessions aren't possible.
- It ensures consistency in treatment.
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 | 7 |
| Year 10 | 9 | 8 |
| Year 20 | 9 | 8 |
college student (suburban Georgia)
Age: 22 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 16/20
Statement of Opinion:
- Telehealth lets me access help between classes without needing to drive long distances.
- It is an essential part of my health plan.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Cost Estimates
Year 1: $85000000 (Low: $80000000, High: $90000000)
Year 2: $70000000 (Low: $65000000, High: $75000000)
Year 3: $60000000 (Low: $55000000, High: $65000000)
Year 5: $50000000 (Low: $45000000, High: $55000000)
Year 10: $60000000 (Low: $55000000, High: $65000000)
Year 100: $70000000 (Low: $65000000, High: $75000000)
Key Considerations
- The potential reduction in healthcare disparities by increasing access to behavioral health services through telehealth, especially in rural or underserved areas.
- Changes in regulatory and reimbursement policies related to telehealth under Medicaid and CHIP.
- Impact of telehealth expansion on existing healthcare providers and potential resistance from segments within the healthcare industry.
- Measures ensuring patient privacy and the security of telehealth platforms.