Bill Overview
Title: Expand Qualified Psychologist Services Act
Description: This bill provides for Medicare coverage of services that are furnished by advanced psychology trainees under the general supervision of clinical psychologists.
Sponsors: Sen. Daines, Steve [R-MT]
Target Audience
Population: People age 65 or older and individuals with certain disabilities
Estimated Size: 65000000
- Medicare is a federal program that provides health coverage for people age 65 or older, and some younger people with disabilities.
- In 2023, approximately 65 million individuals are enrolled in Medicare.
- Psychological services are often needed by older adults due to issues like dementia, depression, anxiety, and other mental health conditions associated with aging.
- Providing coverage for services offered by advanced psychology trainees can improve access to psychological care, leading to better health outcomes for this group.
Reasoning
- The policy targets individuals aged 65 or older, as well as those with certain disabilities, which includes approximately 65 million Americans currently enrolled in Medicare.
- Psychological services are crucial for older adults due to mental health issues associated with aging, hence the inclusion in Medicare could significantly improve mental healthcare access.
- The policy budget suggests prioritization of service availability, potentially benefiting a selected fraction of the target population, especially those with immediate or severe psychological needs.
- The impact on self-reported wellbeing may vary greatly depending on the individual's pre-existing access to psychological care, their current health conditions, and their location relative to service providers.
Simulated Interviews
Retired teacher (Florida)
Age: 72 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 12/20
Statement of Opinion:
- Having trouble accessing psychological support due to cost.
- Feels Medicare coverage would help manage her condition better.
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 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Retired engineer (California)
Age: 67 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- Believes coverage would drastically reduce financial stress related to therapy costs.
- Looks forward to increased mental health support.
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 | 6 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Retired (New York)
Age: 70 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 15/20
Statement of Opinion:
- I think it could provide necessary help for people like me.
- Medicare covering these services is a huge relief.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 6 |
Retired lawyer (Texas)
Age: 75 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 20.0 years
Commonness: 8/20
Statement of Opinion:
- This policy can be life-changing for veterans like me.
- Therapy costs are a big burden—coverage is much needed.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 5 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 4 |
Retired nurse (Ohio)
Age: 68 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 14/20
Statement of Opinion:
- Glad to hear Medicare will support psychological services!
- Better access could help manage stress and anxiety significantly.
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 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Retired postal worker (Arizona)
Age: 80 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- Not sure how beneficial it will be for me personally.
- Concerned about how services will be accessible in rural areas.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
Retired accountant (Illinois)
Age: 66 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 16/20
Statement of Opinion:
- I approve this policy, but let's see how it's implemented.
- Worried whether there will be enough psychologists for demand.
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 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 6 |
Retired mechanic (Michigan)
Age: 69 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 15.0 years
Commonness: 7/20
Statement of Opinion:
- Hoping the policy will cover more extensive therapy sessions.
- Costs are currently prohibitive without insurance.
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 | 7 | 3 |
| Year 10 | 8 | 3 |
| Year 20 | 7 | 3 |
Retired librarian (North Carolina)
Age: 73 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 11/20
Statement of Opinion:
- Medicare coverage is much needed to lessen therapy costs.
- It would give me more flexibility in therapy choices.
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 | 8 | 5 |
| Year 20 | 7 | 5 |
Retired rancher (New Mexico)
Age: 85 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 6/20
Statement of Opinion:
- Not sure I'll directly benefit, since services are far from home.
- Helpful for those who can access it, though.
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 | 6 | 6 |
Cost Estimates
Year 1: $30000000 (Low: $20000000, High: $50000000)
Year 2: $33000000 (Low: $22000000, High: $55000000)
Year 3: $36000000 (Low: $24000000, High: $60000000)
Year 5: $41000000 (Low: $27000000, High: $68000000)
Year 10: $50000000 (Low: $34000000, High: $83000000)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- Training and supervision costs are accounted for under existing clinical settings, minimizing new expenses.
- Anticipated utilization is based on current trends in mental health demand among older adults.
- The true financial benefit might manifest after several years, post initial implementation.