The pandemic put Americans under immense emotional pressure. Many people with pre-existing mental health and substance use disorders struggled to cope, while countless Americans with no previous history suffered the onset of distressing symptoms. In fact, in January 2021, an estimated 41 percent of U.S. adults experienced symptoms of anxiety or depressive disorder.
As we begin returning to a pre-pandemic lifestyle, stresses are bound to increase, making mental and behavioral health care even more important for all Americans.
Recognizing this deepening mental health national crisis, The ERISA Industry Committee (ERIC) engaged a diverse group of our member companies—large, multistate employers that provide health benefits to employees, their families, and retirees—to explore how to increase access to better and more affordable mental and behavioral health care. A comprehensive set of policy recommendations emerged, which we released in “Prioritizing Employee Mental Health: Solutions for Congress,” intended to help federal lawmakers enact effective legislation.
This new report reflects solutions and policy changes Congress can enact to ensure that patients have affordable access to mental and substance use disorder services. Key recommendations from ERIC’s report include:
- Allowing mental health providers to practice across state lines to improve access to care
- Expanding telehealth benefits for all employees to improve access to providers
- Incentivizing more practitioners to enter the mental health field by increasing education funding and tuition reimbursement
- Requiring provider transparency around the ability to accept new patients, reducing patient uncertainty and frustration
- Integrating multiple health care disciplines through collaboration to provide patients with higher quality care
- Ensuring patients and plan sponsors have access to meaningful provider quality and safety information
- Modernizing health care account rules to increase flexibility for employees and improve access to mental and behavioral health
- Reducing regulatory barriers to encourage employer innovation
- Applying lessons learned from COVID-19 to advance health equity and better prepare for the future
- Encouraging the transition to value-based payments to better manage the costs of mental and behavioral health
Employers embraced one of the solutions highlighted in our report by allowing patients to have an affordable telehealth visit without hitting their deductible during COVID-19, thanks to short-term congressional and administration action. However, these temporary rules will soon expire at the end of this year. More policy action is needed to enable all Americans to obtain the care they need, when and where they need it, affordably and conveniently.
Federal and state policymakers can make mental health services immediately available by offering providers automatic interstate license reciprocity, allowing a licensed health care provider in good standing to practice in other states. While it is entirely appropriate for a state to enforce standards to regulate the practice of medicine at brick-and-mortar medical facilities within that state’s geographic boundaries, it makes little sense to have 50 different sets of rules for telehealth (practiced remotely on the internet or via phone) dependent on where a provider or patient may be located. Implementing national telehealth standards would eliminate the patchwork of state rules that sometimes bar patients from making full use of telemedicine, such as obtaining a prescription. Congress has worked on cross-state practice before regarding sports medicine, allowing team physicians to treat players outside of the team’s home state. The need to address cross-state practice for behavioral telehealth is even more pressing now.
Lawmakers can help ease the burden on patients searching for doctors by requiring mental health professionals to indicate whether or not they are accepting new patients in online directories. This is an important step to ensure patients have the proper information upfront, so those who make an effort to seek out an appointment are not demoralized by being turned away by providers.
Several emergency measures have proven so successful that ERIC calls on lawmakers to make them permanent so as not to disrupt access to care. Including the passage of the Telehealth Expansion Act, introduced by Senators Steve Daines and Catherine Cortez-Masto, which allows employers to continue covering telehealth services before an employee meets a health plan deductible. Also, standalone telehealth benefits for part-time workers should be made permanent and expanded to allow employers to offer these benefits services to all employees.
As Congress reexamines the regulatory landscape, they should update rules regarding high-deductible health plans (HDHPs). More than half of U.S. employees are enrolled in these plans, and many are less likely to seek medical care because of costs associated with hitting their deductible. The rules governing these plans hamstring employers who want to experiment with new benefit models to support their workforce. Policymakers need to offer employers greater latitude to innovate.
We are at a pivotal moment for health care, and collaboration between employers and lawmakers is essential to drive the tangible expansion of mental and behavioral health benefits. ERIC and the large employer community stand ready to work with members of Congress as they think through solutions to increase access to high-quality, affordable mental and behavioral health care and improve the lives of employees and their families.
Click here to read more about what lawmakers can do to expand access to mental health care in ERIC’s “Prioritizing Employee Mental Health: Solutions for Congress” report.