House Ways & Means Committee Holds Hearing on America's Mental Health Crisis

On February 2, 2022, the House Ways & Means Committee conducted a hearing entitled “America’s Mental Health Crisis,” during which the Mental Health Access Improvement Act (S.828/ H.R. 432) was mentioned.

During the hearing, the following witnesses testified:

• Wizdom Powell, Ph.D., Director of the Health Disparities Institute and Associate Professor of Psychiatry, UConn Health
• Deborah Steinberg, J.D., Health Policy Attorney, The Legal Action Center
• Peggy Johnson, M.D., Chief of Psychiatry, The Commonwealth Care Alliance
• Angela Sausser, M.S.W., Executive Director, The Public Children Services Association of Ohio
• Deepa Avula, M.P.H., Director of the North Carolina Division on Mental Health, Developmental Disabilities, and Substance Abuse Services at the North Carolina Department of Health & Human Services

In their opening remarks, House Ways & Means Chairman Richard Neal (D-MA) and Ranking Member Kevin Brady (R-TX) stated there is strong bipartisan support for efforts to address the current mental health crisis and acknowledged the nations mental health crisis has been compounded by the COVID-19 pandemic.

Some committee members disagreed about the root cause of the crisis, but several areas of bipartisan agreement emerged, including the desire to extend telehealth flexibilities beyond the public health emergency (PHE) and to strengthen the continuum of care for children suffering from acute mental illness. According to Chairman Neal, this hearing was the first in a series of hearings the House Ways & Means committee will hold on the subject.

 Below is a summary of relevant discussion points from the hearing:

 Addressing Gaps in Medicare Coverage

In his opening statement, House Ways & Means committee Chairman Richard Neal (D-MA) spoke about the importance of strengthening the mental health care continuum by increasing access to mental health providers like Marriage and Family Therapists (MFTs) and Licensed Professional Counselors (LPCs). The Chairman stated that these types of providers can make a “huge impact on people’s lives and on their health.”

Rep. Mike Thompson (D-CA) spoke about the Mental Health Access Improvement Act. He began his line of questioning by noting that seniors suffer from substantial rates of mental illness, especially depression and anxiety, and named the limited supply of mental health professionals available to seniors as a primary driver of these disproportionately higher rates. Following these remarks, the Representative asked Deborah Steinberg how the inclusion of MFTs and LPCs under Medicare would improve access to care for seniors. She responded that MFTs and LPCs make up 40 percent of the mental health care workforce, thus their inclusion under Medicare would have a significant impact on access to care for beneficiaries.

Rep. Linda Sanchez (D-CA) did not explicitly mention LPCs and MFTs in her statements. However, she noted that coverage gaps under Medicare for behavioral health services have made it increasingly difficult for safety net providers to serve vulnerable beneficiaries. As Congress seeks to alleviate the burden on safety net providers, Rep. Sanchez asked Steinberg to name the most glaring barriers preventing Medicare beneficiaries from accessing mental health and behavioral health services. In response, she stated that limited provider coverage under Medicare is among the most glaring barriers. Later in the hearing, Rep. Ron Kind (D-WI) expressed his support for widening the pool of providers available to Medicare beneficiaries by adjusting current Medicare payment and reimbursement policies.

 Extending Telehealth Flexibilities

In his opening statement, Ranking Member Brady expressed his support for permanently extending telehealth flexibilities. The Ranking Member cited recent studies showing that one-third of seniors used telehealth to access mental health services during the pandemic. Rep. Kind also expressed his support for a permanent extension and stated that access to telehealth services is critical for those living in rural areas, particularly ranchers and farmers. Rep. Adrian Smith (R-NE) concurred and added that maintaining audio-only telehealth services is critical for this population given that broadband access is inconsistent in rural areas.

 In his line of questioning, Rep. Lloyd Doggett (D-TX), Chair of the Health Subcommittee, highlighted the Lone Star Circle of Care in Austin, Texas, and stated the facility has seen a 48 percent increase in the use of telehealth for mental health services in the past year. The Representative noted that he recently introduced the Telehealth Expansion Act to ensure continued access to this form of care following the PHE, with appropriate guardrails to prevent fraud and abuse.

We will be closely monitoring all future Committee action on the issue.  If you would like to learn more or become involved in ACA’s advocacy efforts, please contact the ACA government affairs and public policy team at advocacy@counseling.org.