As the country marks two years of living with COVID-19, it is abundantly clear that the lockdowns, closures and social limitations caused by the disease have led to a significant increase in the prevalence of mental health disorders and drug addiction (MH/SUD). Although pandemic life continues to wreak havoc in communities across the country, federal policymakers are responding by moving away from reactionary stopgap measures in favor of forward-thinking systemic changes.
Recently, three federal departments (Labour, Health and Human Services (HHS), and Treasury) released their 2022 report to Congress, arguing for regulatory action on one of the Biden administration’s top health care priorities. behavioral: ensuring that the financial requirements and treatment limitations imposed by insurers on HD/SUD benefits are not more restrictive than those that apply to medical and surgical benefits. The report says the Administration is concerned that insurers are not providing the parity of care required by the Mental Health Parity and Substance Abuse Equity Act of 2008 – even as demand for HD/SUD treatment services increased during the pandemic.
In addition to developing rules that clarify MH/SUD parity requirements under existing law, HHS plans to release regulations this year that would help providers treat opioid use disorder by increasing access to extended doses of on-the-go methadone and enabling medication treatment through telehealth appointments.
After infusing the behavioral health care system with billions of dollars in emergency funding through the passage of the American Rescue Plan Act last year, Congress is now looking to take proactive steps to bolster programs. that facilitate state approaches to address unmet behavioral health needs. And since 2022 is an election year, federal policymakers are prioritizing non-controversial, bipartisan proposals that could pass in what promises to be another politically polarized year.
Specifically, there are several initiatives to watch as the year progresses:
Leaders of the Senate Finance Committee and the Senate Health, Education, Labor and Pensions Committee recently announced plans to prepare a legislative package this summer that would address HD/SUD issues. Both Senate committees, as well as the House Energy and Commerce Committee and the Ways and Means Committee, have held hearings in recent weeks. This recent flurry of congressional activity on both sides of the Capitol represents a concerted bipartisan effort to develop meaningful solutions. It builds on a Senate Finance Committee initiative launched last fall in which the group sought public policy changes from health stakeholders that would increase access to mental health services, make treatment more effective and reduce the financial burdens associated with providing care. This bipartisan effort continues in 2022 as a top priority for Chairman Ron Wyden (DOR) and Ranking Member Mike Crapo (RID). Finding fiscal offsets to pay for large-scale programmatic changes, as well as navigating election-year politics, will be key challenges for lawmakers seeking to improve behavioral health care service delivery.
Another bipartisan initiative launched last year, by the senses. Bill Cassidy (R-LA) and Chris Murphy (D-CT), focus on expanding and improving existing federal HD/SUD programs that are set to expire this year. Stemming from the 2016 21st Century Treatments Act, improvements to these programs could be included in FDA user fee reauthorization legislation that is expected to be considered later this summer.
The House bipartisan Addiction and Mental Health Task Force continues to work on its strong agenda of more than 70 MH/SUD pieces of legislation. The task force has won several legislative victories in 2021 and its leaders hope the bipartisan nature of the caucus will push more bills through the goal line.
Congress is continuing its ongoing efforts to address the epidemic of opioids and other SUDs, exploring how to improve programs launched with the passage of the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act , both of which became law in 2016. Many SUD programs and associated funding are due for reauthorization this year, so updated versions of these laws are being considered in congressional health committees.
Behavioral health stakeholders are calling on Congress to pass an omnibus appropriations bill that will fund federal HD/SUD programs and HD/SUD pandemic response initiatives for the remainder of the fiscal year, which ends on September 30. The federal government is currently funded through a continuing resolution that will expire on February 18. Stakeholders are urging Congress to act quickly to ensure passage of appropriations that will support state mental health block grants, a new national ‘988’ suicide hotline, 24-hour call centers/ 24/7 staffed mental health professionals, mobile response teams and crisis stabilization services that connect people to follow-up care. The stakeholder community sees these investments as critical to meeting pandemic-related behavioral health needs.
© Polsinelli PC, Polsinelli LLP in CaliforniaNational Law Review, Volume XII, Number 62