Congress Should Act on Mental Health

Conventional wisdom says that Congress generally won’t achieve much in a Presidential election year as issues begin to get mired in partisan posturing.  But 2016 has been anything but a conventional election year, and this Congress has the opportunity to pass two important bipartisan health bills this year.

We’re talking about the mental health bills before the House and the Senate as well as the Medicare chronic care legislation under development by the Senate Finance Committee.  These bipartisan proposals could improve the lives of millions of Americans and move our health care system in the direction of better integrated and higher value care. It’s time that Congress act on them.

Chronic disease already accounts for the vast majority of health care costs in Medicare and our health care system in general.   Without action, the problem will only get worse.

According to the Centers for Disease Control and Prevention, in 2012, about half of all adults—117 million people—had chronic health conditions. The number of adults with diabetes or pre-diabetes is more than twice what it was 30 years ago. An analysis by IHS Life Sciences predicts that by 2030, the number of people with three or more chronic conditions will climb from 31 million to 80 million.

In December, the Senate Finance Committee’s Chronic Care Working Group released a package of policy options that could transform how Medicare serves these patients.  The proposals include giving flexibility to Medicare Advantage plans for benefit and cost-sharing improvements and strengthening incentives for providers to improve care coordination in traditional, fee-for-service Medicare. These proposals would go a long way toward aligning Medicare with what is already working in the private sector and the states.

Chronic physical ailments are but one part of the chronic disease problem. Every year, one in four adults in America—or approximately 58 million individuals—suffers from a diagnosable mental disorder. Yet today, less than a third of these adults, and half of children, are identified and diagnosed. This is due in part to a lack of access to mental health care: almost 90 million Americans live in federally-designated Mental Health Professional Shortage Areas.

These gaps in mental health services are imposing real costs on all of us.  Untreated mental illnesses in the U.S. cost more than $100 billion annually in lost productivity.  Medicare spending on enrollees with mental health or substance abuse conditions is two to three times that on other beneficiaries.

Here too, Congress has an opportunity to act. The Senate HELP Committee recently approved bipartisan legislation to strengthen the mental health parity law, encourage adoption of evidence-based programs and interventions to facilitate the integration of mental and physical health. Senators Roy Blunt (R-Mo.) and Debbie Stabenow (D-Mich.), each a member of their party’s leadership, have united to champion community mental health funding.  And the House Energy and Commerce Committee just announced its plans to vote on a newly revised mental health bill.

With all this progress, the enactment of meaningful bipartisan legislation on chronic care and mental health is within reach. But Congress must decide they want to prove the conventional wisdom wrong.

Wanda Filer is the President of the American Academy of Family Physicians and John Rother is the President and CEO of the National Coalition on Health Care.   

Morning Consult