Bill Overview
Title: REMOVE Copays Act
Description: This bill prohibits the Department of Veterans Affairs from imposing or collecting any co-payment for a veteran's first three mental health outpatient care visits in a calendar year. However, such prohibition must not apply with respect to the imposition or collection of copayments for medications.
Sponsors: Sen. Ossoff, Jon [D-GA]
Target Audience
Population: global veteran individuals
Estimated Size: 1500000
- The bill specifically targets veterans who require mental health outpatient services.
- It focuses on reducing the financial burden associated with accessing these mental health services.
- The bill is specific to veterans receiving care through the Department of Veterans Affairs in the United States.
- The prohibition applies to the first three outpatient mental health visits per year per veteran.
Reasoning
- The veteran population in the U.S. is about 18 million, but the bill targets those accessing mental health outpatient services specifically through the VA.
- Given the prevalence of PTSD and other mental health issues, it's estimated that about 20% of veterans experience mental health issues, reducing the subset possibly affected to around 1 to 2 million veterans.
- The policy covers the first three visits per veteran each year, which alleviates initial financial burdens but does not address medication copays.
- With a budget cap of $45 million in the first year, this allows for a significant, but not complete, relief for a large number of veterans, as the cost savings would need to be spread across those utilizing the benefit. This requires careful selection for meaningful impact per person.
- The commonness of the simulated individuals reflects the estimated target group affected by the policy.
Simulated Interviews
Veteran, unemployed (Texas)
Age: 36 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 15/20
Statement of Opinion:
- This policy will help me a lot in getting the therapy sessions I need without worrying too much about initial costs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Veteran, IT specialist (California)
Age: 28 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 13/20
Statement of Opinion:
- It makes it easier to stick to my therapy schedule knowing that my first few visits each year are covered. Less stress about choosing between this and other expenses.
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 | 6 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Veteran, maintenance worker (Florida)
Age: 42 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 4.0 years
Commonness: 12/20
Statement of Opinion:
- This is a huge help. I've been putting off therapy because of costs.
- Now I can start my sessions without worrying too much initially.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Veteran, retired (Virginia)
Age: 59 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 1.0 years
Commonness: 11/20
Statement of Opinion:
- The copay relief is beneficial, but medications are still a significant cost.
- Being retired, managing expenses is always a priority.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 5 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Veteran, freelancer (New York)
Age: 31 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 14/20
Statement of Opinion:
- This change helps in making therapy affordable, especially since my income isn't stable.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Veteran, small business owner (Illinois)
Age: 47 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 1.5 years
Commonness: 10/20
Statement of Opinion:
- The policy is beneficial even if my copays are currently covered initially by private insurance. It's good to have more support.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Veteran, retired third-grade teacher (Ohio)
Age: 62 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 13/20
Statement of Opinion:
- I wish medication was included too, but getting a break on therapy visits is a relief.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Veteran, student (Colorado)
Age: 25 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 3.5 years
Commonness: 16/20
Statement of Opinion:
- This is ideal timing. I can focus on therapy without worrying about extra costs initially each year.
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 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Veteran, government contractor (Washington)
Age: 53 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 2.0 years
Commonness: 11/20
Statement of Opinion:
- The copay removal helps, but other payments are a strain. Nevertheless, initial relief is always welcome.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 6 | 6 |
| Year 20 | 5 | 5 |
Veteran, mechanic (North Carolina)
Age: 37 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 1.0 years
Commonness: 13/20
Statement of Opinion:
- It's a small but important lift off my back. The fewer costs I have to manage, the better.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 5 | 5 |
Cost Estimates
Year 1: $45000000 (Low: $30000000, High: $60000000)
Year 2: $45000000 (Low: $30000000, High: $60000000)
Year 3: $45000000 (Low: $30000000, High: $60000000)
Year 5: $45000000 (Low: $30000000, High: $60000000)
Year 10: $45000000 (Low: $30000000, High: $60000000)
Year 100: $45000000 (Low: $30000000, High: $60000000)
Key Considerations
- There might be an increase in demand for mental health services due to reduced barriers to access, which should be monitored.
- Ensuring sufficient resource allocation to mental health services within the Veterans Affairs framework to handle potential increased demand is vital.
- Evaluating the broader impacts on veterans' mental health and well-being could provide valuable insights into the policy's effectiveness.