Legislation Would Increase Federal Reimbursement for Mental and Behavioral Health Care Under Medicaid

WASHINGTON, D.C. [05/26/21]—U.S. Senator Tina Smith (D-Minn.) introduced legislation—along with Sen. Debbie Stabenow (D-Mich.)to expand access to mental health services for low-income families and children, the elderly and people living with disabilities. The Medicaid Bump Act would increase the federal reimbursement rate for mental and behavioral health care services under Medicaid. A House companion bill was introduced by U.S. Representatives Paul D. Tonko (D-NY-20) and David Trone (D-MD-6) 

Right now, behavioral health providers—including adolescent and pediatric specialists—are often reimbursed by Medicaid at low rates. Furthermore, there is a shortage of behavioral health providers, particularly in rural and underserved communities. These barriers contribute to inequities in access to mental and behavioral health care services for thousands of Americans.

“When I experienced depression, resources were there for me. But right now, too many people don’t have access to the mental or behavioral health care they need,” said Sen. Smith. “This bill will improve equity in access to mental and behavioral health care by helping low-income families, the elderly, and people living with disabilities access resources. I want anyone suffering from a mental health issue to know they are not alone. We can all help break the stigma by talking about it, and then we have to go to work to get people the services they need.”

“The COVID-19 crisis has shown a spotlight on the urgent and continuing need to fund comprehensive community mental health and addiction services,” said Sen. Stabenow. We should treat health care above the neck the same way we treat health care below the neck. Senator Smith and I introduced this bill to help close the gap in services and help people get the care they need.

This past year has had a negative impact on people's mental health. We've seen an increase in depression, anxiety and suicidal ideation, said Sue Abderholden, Executive Director of NAMI MN, Our mental health system does not have the resources to respond because of the low reimbursement rates for behavioral health providers. Increasing the federal Medicaid match will provide additional funds to our mental health system at a time when we are facing workforce shortages. These dollars will help attract more providers and expand services to meet the increased needs of our communities.

“We are in the midst of an unprecedented mental health crisis among our youth, not only in Minnesota, but nationwide. The COVID-19 pandemic has only worsened the situation,” said Dr. Marc Gorelick, President and CEO of Children’s Minnesota. “We need to champion the health needs of kids in our community by making sure that behavioral and mental health services are accessible to everyone, regardless of their insurance status. With Medicaid as the number one insurer of kids, this legislation will help ensure that all children receive the care they so desperately need.” 

Sen. Smith’s Medicaid Bump Act of 2021 would address these problems by creating a financial incentive to increase State Medicaid spending on behavioral health services. Specifically, this bill would:

  • Provide an enhanced Medicaid Federal Medical Assistance Percentage (FMAP) rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels;
  •  Require States to use the additional federal funds as a supplement rather than a replacement of State funding levels, and to use the funds to increase capacity, efficiency, and quality of behavioral health services;
  • Direct the Secretary of Health and Human Services (HHS) to define which services qualify as eligible behavioral health services for the enhanced FMAP; and
  • Require HHS to provide annual reports on the impact of increased federal Medicaid reimbursement on the utilization of behavioral health services in each State.

The Medicaid Bump Act of 2021 is supported by is supported by RI International, Inc., American Psychological Association, the Kennedy Forum, NAMI, American Foundation for Suicide Prevention, National Association for Behavioral Healthcare, National Association for Children’s Behavioral Health, NAADAC: the Association for Addiction Professionals, International OCD Foundation, The Psychotherapy Action Network Advocacy, American Association on Health and Disability, Lakeshore Foundation, American Nurses Association, National Association of Social Workers, National Association of Pediatric Nurse Practitioners, National League for Nursing, NAMI MN, Children’s MN, Fraser, Minnesota Association of Community Health Centers, Minnesota Association of Community Mental Health ProgramsHennepin Healthcare, Northwestern Mental Health Center, and Allina Health.

You can read a summary of the bill here.

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