The election results of November mean 2011 will be a year of new faces on Capitol Hill. One-fifth of the 112th Congress will be freshmen. Many may not be aware of mental health issues.

A review during the campaign of federal candidate websites conducted by a Rhode Island group found that mental health didn't seem to be on the radar for most. Only a quarter of major-party candidates posted information indicating support for any mental health issue. And only one candidate had a clearly delineated set of mental health policy proposals—Providence Mayor David N. Cicilline, who won election to fill the seat of mental health champion Rep. Patrick J. Kennedy.

Educating new members about mental health issues is one challenge we will face in the New Year. Another will be defending the new health care reform law.

There has been a great deal of discussion whether the new GOP House majority will carry out a pledge to repeal the health care reform law. Outright repeal is unlikely to go very far. It would be opposed by the Democratic-controlled Senate and vetoed by President Obama.

But lawmakers could try to eliminate funding to implement the law and use spending bills to block regulations to which they object. And they could move to limit enforcement of provisions that require people to obtain insurance. In addition, GOP leaders may try to hold hearings to highlight unpopular aspects of the law. That could turn out to be a two-edged sword because it would also provide a platform for the administration to better communicate the benefits of health reform.

We also recognize that a number of key decisions on implementation will be made at the state level. The new exchanges that will be established are state-based and insurance commissioners will set regulations on how they will work. Each state will also determine whether to administer the exchange itself or allow a private entity or the federal government to do so. States also have the option of joining together and developing regional exchanges with their neighbors.

Another arena where the future path of health reform may be determined is the courts. A federal judge in Virginia ruled the law unconstitutional because of the requirement that almost all Americans purchase insurance. Several other lawsuits have been dismissed and others are pending. The ruling is not expected to have an impact on implementation of the law, but the issue will most likely be decided by the U.S. Supreme Court. Mental Health America and several other organizations signed onto a friend of the court brief supporting the law in the Virginia case and a related federal court case in Florida.

Funding of government programs that support mental health services will continue to be a priority for Mental Health America. Changes pushed by presumptive House Speaker John Boehner (R-Ohio) would break up the 12 annual appropriations bills for government agencies into smaller measures. He has said that cutting spending would be easier if the bills were more narrowly focused.

As you know, bills that were not enacted in the 111th Congress—such as the Health Information Technology Extension for Behavioral Health Services Act of 2010 (HR 540/S 3709) and the Mental Health in Schools Act (HR 2531)—will need to be re-introduced next year.

The 112th Congress will convene on January 5. Your advocacy will be needed in the months ahead to support our efforts to protect the important gains we have made. ::

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