The American Counseling Association (ACA) commends the recent release of the Senate Finance Committee (SFC) report, “Mental Health Care in the United States: The Case for Federal Action” and their work to support bipartisan mental health initiatives. This report comes after the SFC’s September Request for Information (RFI) and compiles the mental health challenges in America.
There are approximately 1 in 5 adults suffering from a diagnosable and treatable mental health illness, and in 2020, over 40 million Americans were diagnosed with substance use disorder (SUD). Exacerbated by COVID-19, the Government Accountability Office reported on the prevalence of mental health conditions and reported symptoms of anxiety or depression have increased 29% between April 2020 and April 2021, with nearly 40% of adults experiencing symptoms.
The SFC report provides data from the Substance Abuse Mental Health Services Administration (SAMSHA) and the Health Resources and Services Administration (HRSA) to support the lack of health care providers to meet the current need. Mental health professional shortage areas (HPSA) account for about 13 million Americans in total, of which 60% are in rural and underserved communities. While behavioral health spending has increased by 62% since 2006, HRSA projects a shortage of 24,060 providers by 2030. The RFI policy recommendation is to expand eligibility for payment under Medicare to include Licensed Professional Counselors (LPC) and Marriage and Family Therapists (MFT).
Furthermore, the report includes the challenge of mental health and SUD parity not being met. Federal parity requirements are not universal among federal health programs. Thus, federal parity requirements under Medicare does not apply to Medicare fee for service, excludes LPCs and MFTs in the Medicare program, and only provides partial coverage of limited situations hospitalizations. This challenge is a barrier to care for millions of Americans.
During the COVID-19 pandemic, the role of telehealth in connecting patients to necessary mental health care increased significantly. Under Medicare in 2019, there were 840,000 telehealth visits, whereas in 2020, this increased to 52.7 million telehealth visits, of which one-third accounted for behavioral health visits. Moving forward, the RFI policy recommendation is to eliminate the Consolidated Appropriations Act’s (CAA) in-person visit requirement for mental health and SUD condition treatment and reimburse for audio and tele-behavioral health care.
The ACA Government Affairs and Public Policy team is following this matter closely and will inform you of any updates. If you would like to become involved in ACA’s advocacy efforts, please contact the ACA Government Affairs and Public Policy team at advocacy@counseling.org.