Federal lawmakers have introduced or revived several bills this year aimed at expanding access to addiction and mental health treatment, from new Medicare coverage for residential opioid treatment to permanent funding for community behavioral health clinics.
Here are eight to know:
1. U.S. Rep. Adam Smith, D-Wash., introduced the bipartisan 988 Crisis Response Act Sept. 3 to fund professional mobile crisis response teams dispatched by 988 Lifeline operators as well as establish Medicaid reimbursement for crisis call centers and resources.
The legislation would authorize $100 million for the Mental Health Crisis Response Partnership program for communities to create or enhance existing mobile crisis response teams, according to a Sept. 3 news release from Mr. Smith’s office.
The bill would also make permanent the 85% federal matching assistance percentage for mobile crisis response teams and expand it to crisis call centers and crisis stabilizing and receiving facilities.
Current law only lets states claim the enhanced 85% Medicaid match for mobile crisis intervention services during a 5-year adoption window from April 2022 through March 2027, and even then, only for the first three years after a state opts in. This bill removes both time limits, making the option available indefinitely and the higher match rate permanent for states that qualify.
2. U.S. Sens. Dave McCormick, R-Pa., and John Fetterman, D-Pa., introduced the Workforce Recovery and Resilience Act to help communities affected by the opioid and fentanyl crisis recruit, train and strengthen the workforce supporting addiction prevention, treatment and recovery.
The legislation would modernize the Workforce Innovation and Opportunity Act by giving state and local workforce boards new tools to address workforce challenges related to substance use disorders. The bill also would expand National Dislocated Worker Grants to support employment and training related to addiction prevention, treatment, mental healthcare and pain management, while broadening eligibility for the grants.
3. Sens. Edward J. Markey, D-Mass., and Jeff Merkley, D-Ore., reintroduced the Equity in Pretrial Health Coverage Act Aug. 4, legislation that would preserve federal health benefits for individuals detained while awaiting trial and protect access to substance use disorder treatment and mental healthcare while incarcerated.
The legislation would maintain coverage under Medicaid, Medicare, the Children’s Health Insurance Program and the Department of Veterans Affairs for eligible individuals in pretrial detention. It would also partially reverse the 1965 Federal Medicaid Inmate Exclusion Policy, which generally prohibits the use of federal Medicaid funding for inmates of public institutions.
Under current policy, people who post bail generally retain their health coverage, while those who remain in custody because they cannot afford bail can lose coverage despite not being convicted of a crime. The release said the resulting gap in coverage is particularly challenging for people with substance use disorders and other mental health conditions that require consistent treatment.
4. Congressman David Valadao, R-Calif., joined Reps. Lauren Underwood, D-Ill., Carol Miller, R-W.Va., and Paul Tonko, D-N.Y., in reintroducing the Residential Recovery for Seniors Act on July 6, which would authorize Medicare coverage for residential and inpatient treatment for opioid use disorder.
The legislation would create a new Medicare benefit covering residential treatment that meets American Society of Addiction Medicine standards. It would include low-intensity, high-intensity and medically managed residential treatment, as well as establish a fixed Medicare payment system for participating treatment providers.
Mr. Valadao said the bill is intended to address rising overdose deaths among older adults by expanding access to residential addiction treatment for Medicare beneficiaries. Medicaid already covers residential addiction treatment, while many Medicare beneficiaries lack coverage for those services.
5. Sens. Edward Markey, D-Mass., and Rand Paul, MD, R-Ky., on June 25 reintroduced legislation that would allow board-certified physicians to prescribe methadone for opioid use disorder and pharmacies to dispense the medication, according to a news release from Mr. Markey’s office.
The Modernizing Opioid Treatment Access Act would expand access to methadone, which is currently available to patients with opioid use disorder only through opioid treatment programs. Patients typically must travel to an opioid treatment program daily or nearly every day early in treatment and, on average, drive 4.5 times farther to reach one than a pharmacy, the release said.
The legislation builds on a version that passed the Senate Committee on Health, Education, Labor and Pensions in December 2023 by allowing HHS to designate additional licensed providers who can prescribe methadone for opioid use disorder without additional legislation.
6. A bipartisan group of federal lawmakers in the House introduced the Ensuring Excellence in Mental Health Act to expand behavioral healthcare access.
The legislation was introduced by Rep. August Pfluger, R-Texas, Doris Matsui, D-Calif., Craig Goldman, R-Texas, Angie Craig, D-Minn., Mark Alford, R-Mo., Paul Tonko, D-N.Y., and Brian Fitzpatrick, R-Pa., It would permanently authorize the Certified Community Behavioral Health Clinic model and allow states the option to implement it within their behavioral healthcare systems.
The bill aims to address gaps in care as demand for behavioral health services rises. CCBHCs provide a range of services, including 24/7 crisis care, outpatient mental health and substance use treatment, screening and diagnosis, and coordination with hospitals, law enforcement and veterans organizations.
The legislation would also establish a Medicare payment structure for CCBHCs, codify Medicaid payment systems, create an accreditation process and authorize expansion grants and data infrastructure for clinics.
A bipartisan group of senators introduced its own version of the Ensuring Excellence in Mental Health Act in December.
7. On March 25, U.S. Sens. John Barrasso, R-Wyo., and Chris Coons, D-Del., introduced the Mental Health Access and Provider Support Act.
The bipartisan legislation would increase Medicaid reimbursement rates for clinical social workers, marriage and family therapists and mental health counselors from 75% to 85% of the Physician Fee Schedule amount for covered mental health services.
The act aims to expand access to mental health services and address workforce shortages by aligning reimbursement rates for those providers with other mental health professionals.
8. Lawmakers have introduced the Mental Health Workforce Act to address workforce shortages and expand diversity among mental health providers.
The bill aims to increase the number of providers and expand the pipeline of diverse professionals, according to a March 19 news release from the office of Rep. Troy Carter, D-La. It includes student loan forgiveness for individuals who attend Historically Black Colleges and Universities and Minority Serving Institutions in exchange for a five-year service commitment after becoming licensed.
As part of the program, providers would be required to serve patients in health professional shortage areas. Federal data shows 92.3 million people lived in primary care health professional shortage areas as of Dec. 25.
The legislation also seeks to address disparities in access to mental healthcare. Data from the American Psychology Association shows psychologists were 85% white in 2011 and 80% white in 2021.
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