Bill Overview
Title: Behavioral Health Network and Directory Improvement Act
Description: This bill increases oversight of health insurance plans' provider directories and revises the network adequacy standards with respect to the accessibility of mental health and substance use disorder providers.
Sponsors: Sen. Smith, Tina [D-MN]
Target Audience
Population: People with mental health and substance use disorders
Estimated Size: 52300000
- The bill addresses mental health and substance use disorder providers, indicating it will affect individuals seeking these services.
- Access and network adequacy are common issues affecting a broad base of individuals looking for healthcare services.
- Mental health and substance use disorders are prevalent worldwide, implying a global impact.
Reasoning
- The budget suggests a substantial investment, but its reach is finite given the size of the target population. Hence, impacts will vary from none to significant across individuals, depending on how severely they are currently affected by access issues.
- Mental health and substance use disorder services are essential for a large demographic in the US, indicating widespread but uneven impact.
- In crafting these simulations, it is crucial to include diverse demographics to capture a broad range of experiences and impacts. This includes people with different severities of mental health issues, geographical challenges, and varying levels of current satisfaction with their health plans.
Simulated Interviews
Marketing Specialist (New York, NY)
Age: 34 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 14/20
Statement of Opinion:
- It can be frustrating when I can’t find an in-network provider that's accepting new patients.
- Having more options would probably make finding and accessing care much less stressful.
- If the policy works as intended, it could relieve some of my anxiety about actually getting the care I need.
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 | 8 | 5 |
| Year 20 | 7 | 5 |
Construction Worker (Rural Kentucky)
Age: 45 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- Given how hard it is to find help where I live, anything that makes these services more reachable would be a godsend.
- If specialist providers are added to the network, it might mean I wouldn’t need to travel as far or pay as much out of pocket.
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 | 9 | 4 |
| Year 20 | 9 | 4 |
Freelance Graphic Designer (Los Angeles, CA)
Age: 29 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 12/20
Statement of Opinion:
- Access hasn't been a huge issue for me because teletherapy is an option.
- However, it would be great for more specialists to be covered under my plan. That would help if I need different kinds of support in the future.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
College Student (Chicago, IL)
Age: 22 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 15/20
Statement of Opinion:
- The directories are very misleading sometimes, showing providers that aren’t accepting new patients.
- With this policy, hopefully I can find someone close by who accepts my insurance.
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 | 7 | 5 |
| Year 20 | 6 | 5 |
Small Business Owner (Phoenix, AZ)
Age: 53 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 7.0 years
Commonness: 7/20
Statement of Opinion:
- Currently, most of my providers aren't covered, which is costly.
- It's tiring to search for affordable and credible mental health services.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 8 | 3 |
| Year 20 | 7 | 3 |
Retired (Tampa, FL)
Age: 62 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 13/20
Statement of Opinion:
- I usually try to find someone local when I need help, but it's been hard due to lack of options in-network.
- More therapists and counseling services would be convenient for someone like me, who values face-to-face interactions.
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 | 7 | 6 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Tech Support Manager (Houston, TX)
Age: 50 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- New standards could open doors for seeing more experienced therapists covered by my insurance.
- It's often the out-of-network costs that prevent me from seeing the right specialists.
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 | 8 | 4 |
| Year 20 | 7 | 4 |
Teacher (Seattle, WA)
Age: 38 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 11/20
Statement of Opinion:
- The policy might simplify finding specialists and improve the quality of support available through my current plan.
- I'm hopeful but I'll need to see those changes actually taking place.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Social Worker (Miami, FL)
Age: 42 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- For those who face difficulty in accessing support, this seems like a promising strategy to ease some of those burdens.
- If implemented well, it can bridge the gap between need and service availability.
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 | 5 |
| Year 20 | 7 | 5 |
Student (San Diego, CA)
Age: 19 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 6.0 years
Commonness: 16/20
Statement of Opinion:
- It's really tough not having enough nearby options within my plan, but there's hope that this law helps.
- The policy might help students like me by providing better coverage locally.
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 | 4 |
| Year 20 | 7 | 4 |
Cost Estimates
Year 1: $270000000 (Low: $200000000, High: $340000000)
Year 2: $280000000 (Low: $210000000, High: $350000000)
Year 3: $290000000 (Low: $220000000, High: $360000000)
Year 5: $300000000 (Low: $230000000, High: $370000000)
Year 10: $0 (Low: $0, High: $0)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- Establishing a sustainable and effective oversight mechanism is critical to the success of this act.
- Administrative and implementation costs might be higher initially as systems are put in place.
- Long-term savings through improved access to mental health services need consideration.