The Urgent Need for Mental Health Insurance Reform
Our country is facing a mental health crisis, yet insurance companies continue to impose outdated and inadequate policies that limit access to care. A significant number of mental health and substance use (MH/SU) providers are leaving insurance networks due to poor reimbursement rates and unnecessary bureaucratic hurdles. This results in fewer in-network providers, forcing patients to pay out-of-pocket for essential care at far higher rates than other medical services. This has real implications for clients and families at Arcus Behavioral Health and Wellness.
The Stark Reality:
Inadequate Insurance Networks: Many mental health and substance use clinicians opt out of commercial insurance networks due to low reimbursement rates and administrative barriers that make it difficult to provide care.
Limited & Meaningless Coverage for Patients: Patients seeking behavioral health treatment are forced to go out-of-network 18% of the time, compared to only 2% for other healthcare services (Milliman Report). Insurers have addressed shortages in other areas, such as primary care, but have failed to do so for behavioral health.
A Growing Crisis, Same Insurance Practices:
40% of youth report depressive symptoms, hopelessness, or suicidal thoughts.
Black children under 13 die by suicide at twice the rate of white children.
Adult depression has quadrupled since 2019.
Insurance Companies Pay Mental Health Providers Less: Studies show that behavioral health services are reimbursed 23-52% less than comparable medical services (RTI Report), discouraging providers from accepting insurance and worsening access to care.
Investing in Behavioral Health Reduces Overall Costs: Research shows that increasing insurance spending on behavioral health reduces total healthcare costs by 5-10% because mental health conditions often drive other expensive health problems (Milliman Report).
HB1085 / SB55: A Solution to Improve Access to Care
It’s time for meaningful legislative action to ensure fair and adequate coverage for mental health and substance use treatment. The HB1085 / SB55 bill addresses these critical issues by:
Ensuring Fair Payment for Mental Health Services:
Establishes minimum reimbursement rates for in-network MH/SU providers at 141% of Medicare rates, aligning behavioral health with other medical services.
Expanding the Behavioral Health Workforce:
Allows pre-licensed providers to practice under supervision, increasing the number of available mental health professionals and expanding access to care.
Requiring Insurance to Cover MH/SU Services on the Same Day:
Patients should not be denied access to multiple necessary services on the same day due to arbitrary insurance restrictions.
Ensuring Coverage for Full-Length Therapy Sessions:
Prohibits insurers from imposing excessive documentation or audit requirements that pressure therapists to shorten sessions from 60 minutes to 45 minutes.
Mandating a Timely 60-Day Contracting Process for MH/SU Providers:
Reduces unnecessary delays and ensures that providers can join networks quickly to meet the growing demand for mental health services.
TAKE ACTION! Show Your Support for HB1085 / SB55
One of the best ways to show state legislators strong support for HB1085 is by “slipping” as a PROPONENT for the bill. This is a crucial step in ensuring that lawmakers understand the widespread need for these reforms.
How to Slip as a Proponent:
HB1085 will be heard in the House Mental Health & Addiction Committee on Thursday at 10 AM. We need as many "slips" as possible—share this widely with your networks!
Follow These Steps to Submit Your Slip:
Click Here to SLIP AS A PROPONENT!
Fill Out Your Information:
If you are slipping on behalf of an organization or business, use organizational info.
If you are slipping as an independent person, put “Self” on the lines regarding firm/agency, title, and persons represented.
Fill in the Following Details:
Firm/Agency: Your organization; If doing this as an individual, put “Self”.
Title: Your organizational title; If doing this as an individual, put “Self” (This must be completed for processing).
Persons/Groups Represented: Organization or “Self”.
Position: Be sure to check PROPONENT! Also, ensure HCA1 is selected in the dropdown menu (House Committee Amendment 1).
Testimony: Check “Record of Appearance Only” (this shows support but does not require you to speak or submit written testimony).
Agree to the Terms: Check the box.
Submit Your Slip: Click the “Create Slip” button.
Confirmation: You should receive an email receipt confirming your slip submission.
Your support can help create a system where mental health care is accessible, affordable, and valued just as much as any other healthcare service. Act now!
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