Bill Overview
Title: Investing in Kids’ Mental Health Now Act of 2022
Description: This bill temporarily increases the payment rate for pediatric mental, emotional, and behavioral health services, including telehealth services, under Medicaid. The Centers for Medicare & Medicaid Services must issue guidance on how states may expand such services through provider flexibilities and other regulatory pathways.
Sponsors: Sen. Portman, Rob [R-OH]
Target Audience
Population: Children in need of mental health services
Estimated Size: 14000000
- The bill involves Medicaid, so it impacts children who are eligible for Medicaid services.
- It specifically targets pediatric mental, emotional, and behavioral health services, focusing directly on children.
- Telehealth services are included, indicating that children with access to these services will also be impacted.
- Payment rate increases under Medicaid suggest an extension of services or improvements in service delivery, indirectly affecting families of pediatric patients.
- The guidance provided by the Centers for Medicare & Medicaid Services will influence how states implement changes, impacting all states that adapt their services accordingly.
Reasoning
- The target population emphasizes children, specifically those eligible for Medicaid; therefore, the simulated individuals should have children or be connected to the pediatric mental health system.
- Given the restriction in budget and the significant population size needing services, many individuals might see low to moderate impact unless they have urgent needs or are in underserved areas.
- Telehealth's inclusion suggests individuals in rural or underserved urban areas are more likely to witness notable impact due to increased access opportunities.
- To encapsulate a diversity of perspectives, interviews should include parents, healthcare providers, and children from various socioeconomic backgrounds and geographical locations.
- We should also model individuals unaffected by the policy to reflect its selective applicability and budget constraints.
Simulated Interviews
Homemaker (rural Alabama)
Age: 35 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- This bill could be a game-changer for my child. We've struggled to find affordable mental health support and have to travel far to see specialists.
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 | 6 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 3 |
Psychiatrist (urban California)
Age: 42 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- Increased Medicaid payments could allow us to broaden our services and reach more kids, especially with telehealth.
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 | 7 | 6 |
Nurse (suburban Florida)
Age: 29 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 12/20
Statement of Opinion:
- This policy might improve our ability to offer services to children who otherwise wouldn't get mental health support, though sustainability is a concern.
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 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Single parent (urban New York)
Age: 38 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 8.0 years
Commonness: 7/20
Statement of Opinion:
- I worry every day about my child's mental wellness. A better chance to access professional help is something we desperately need.
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 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 3 |
Teacher (rural Texas)
Age: 26 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 7.0 years
Commonness: 11/20
Statement of Opinion:
- I'm hopeful this can bring more support to our kids who need it—especially those who face the greatest barriers in accessing mental health care.
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 | 8 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
Policy Analyst (urban New York)
Age: 45 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 13/20
Statement of Opinion:
- This policy is a step in the right direction for preventing crises in children's mental health. It depends heavily on states' implementation.
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 |
School Principal (urban Chicago)
Age: 50 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 15/20
Statement of Opinion:
- I'm cautiously optimistic. We need more school partnerships with mental health providers to see the full benefit.
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 | 8 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Unemployed (suburban Utah)
Age: 30 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 6.0 years
Commonness: 9/20
Statement of Opinion:
- We struggle with getting the right help for my kid's anxiety. It's too expensive or too far away.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 4 | 3 |
| Year 20 | 3 | 2 |
Social Worker (urban Seattle)
Age: 48 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 14/20
Statement of Opinion:
- Every improvement in mental health care access can have a ripple effect. But temporary measures need a long-term vision.
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 | 6 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Student (rural Ohio)
Age: 16 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 7.0 years
Commonness: 6/20
Statement of Opinion:
- I just want to feel better and not stress my family out with costs for finding help.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 3 | 2 |
Cost Estimates
Year 1: $500000000 (Low: $400000000, High: $600000000)
Year 2: $500000000 (Low: $400000000, High: $600000000)
Year 3: $250000000 (Low: $200000000, High: $300000000)
Year 5: $0 (Low: $0, High: $0)
Year 10: $0 (Low: $0, High: $0)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- The bill's temporary nature limits long-term cost implications but impacts the federal budget significantly in the short term.
- The effectiveness of telehealth services will rely heavily on infrastructure and state-level capacities.
- State-level variations in implementing guidance could affect the uniformity and effectiveness of the intended benefits.