Should CHIP Plans Provide Mental Health and Substance Abuse Treatment? (H.R. 3192)
Do you support or oppose this bill?
What is H.R. 3192?
(Updated March 2, 2020)
This bill would require all Children’s Health Insurance Program (CHIP) plans to cover mental health and substance abuse treatment. Additionally, it would prohibit states from imposing lower financial or utilization limits on mental health treatment than those placed on physical health treatment.
Argument in favor
Mental health and substance abuse treatment are important components of health care. CHIP, as a federal health plan for pregnant women and children, should include this coverage as part of holistic care for its enrollees.
Argument opposed
Mental health systems are built at the state, rather than the federal, level. Changing the mental health coverage requirement in CHIP — a federal program — could interfere with states’ requirements.
Impact
CHIP enrollees; and CHIP health plans.
Cost of H.R. 3192
The CBO estimates that this bill will have no budgetary effect, because all CHIP enrollees are already in plans that meet the mental health and substance abuse treatment requirements of this bill.
Additional Info
In-Depth: Sponsoring Rep. Joe Kennedy III (D-MA) introduced this bill to ensure that all pregnant women and children covered under CHIP have mental health support:
“For generations, our nation’s failure to guarantee and enforce mental health parity has left families helpless as their loved ones suffer in silence… Even in the midst of a deeply contentious health care debate, support for children and pregnant women experiencing mental illness should unite my colleagues on both sides of the aisle. As Congress considers the reauthorization of CHIP, extending the simple promise of parity to these beneficiaries must be a priority.”
The American Psychological Association Practice Organization (APAPO) supports this bill as a means to improve mental health access for the children and pregnant women enrolled in CHIP. In addition to the APAPO, numerous organizations including the American Hospital Association and United Way authored a joint letter expressing their support for the bill.
There are 22 cosponsors of this bill, including five Republicans and 17 Democrats.
Of Note: CHIP covers 8.9 million children and pregnant women in the United States. In general, CHIP plans already include mental health coverage and substance abuse treatment; so this bill would not substantively change enrollees’ coverage. There remain, however, 5% of current CHIP plans with limited or no access to mental care — and in these cases, this bill would expand their enrollees’ coverage to include mental health and substance abuse treatment.
There is precedent for the federal government using its power to require mental health coverage in plans. Under the Affordable Care Act, plans offered through health insurance exchanges are required to cover services for mental health and substance use. Additionally, there is generally mental health coverage in private plans. In 2015, 91% of employer health plans covered mental health treatment, up from 4% in 2014. Taken together, these two facts illustrate the movement towards considering mental health and substance abuse support as part and parcel of health coverage.
Media:
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Cosponsoring Rep. Grace Napolitano (D-CA) Press Release
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CBO Cost Estimate
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American Psychological Association Practice Organization (In Favor)
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Letter of Support by Numerous Organizations
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American Hospital Association (In Favor)
Summary by Lorelei Yang
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