Capitol Hill Update

Mental Health Championed in Stimulus Package

The 2009 economic stimulus package includes several promising measures toward better mental health coverage

The Obama Administration hit the ground running in January, successfully moving through Congress several major pieces of legislation including significant health care provisions. The economic stimulus package, called the American Reinvestment and Recovery Act (ARRA), enacted on February 17 included substantial funding to maintain health care coverage and a number of other initiatives considered elements of health care reform. Many provisions of the ARRA were actively supported by Mental Health America, including an $87 billion increase in federal funding of Medicaid payments to states between October 2008 and January 2011. The legislation also further delays controversial regulatory changes to Medicaid that would restrict reimbursement for rehabilitative, case management, and school-based services.

While widespread adoption of health information technology (HIT) is viewed as a key component of health care reform, the Administration secured early adoption of a comprehensive federal initiative to support development and implementation of HIT as part of the ARRA. The legislation provides $19 billion in grants to states and incentive payments to providers while establishing important new privacy protections.

Mental Health America advocated in support of many of these consumer protections, including a prohibition on the sale of personal medical information without permission, a requirement that consumers be provided an accounting of all disclosures upon request, required notification of consumers if their privacy is breached, and enhanced enforcement of security requirements.

The ARRA also includes significant new funding ($1.1 billion) for comparative effectiveness research (CER), widely described as critical to health care reform by key advisors to President Obama and leaders in Congress.  Mental Health America has advocated for years for greater inclusion of consumer representatives on any entities overseeing funding and priorities for CER.  Although the ARRA program on CER does not reflect this principle, we have been more successful in securing consumer representation in legislation establishing a longer-term CER program sponsored by Senators Max Baucus (D-Mont.), Finance Committee Chairman, and Kent Conrad (D-N.D.), Budget Committee Chairman.  We expect that their legislation will be taken up by Congress later this year.

Even before the ARRA was enacted, a reauthorization of the State Children’s Health Insurance Program (SCHIP) was signed into law on February 4..  This new law expands health care coverage to an additional four million children who would otherwise be uninsured.  We have advocated strongly in favor of this legislation which was previously vetoed twice by President Bush.  Mental Health America also led an effort to win inclusion of an explicit parity requirement in the legislation. While this provision does not require CHIP plans to cover behavioral health services—as is true with the Wellstone-Domenici parity law, almost all do and they are now prohibited from imposing more restrictive treatment limitations or higher financial requirements than required for medical or surgical benefits.

The President and Congressional leaders have signaled that they view enacting health care reform legislation to be a national priority.  The President’s budget proposals issued February 26 included a $634 reserve fund and eight principles for health care reform.  These principles focused primarily on improving access to coverage and reducing cost. But it also called for increased investment in prevention and wellness and improved patient safety and quality.  Congressional leaders are hard at work crafting legislation they hope to act on this summer.  It’s going to be a very busy spring!