TL/DR –
A report by mental health advocacy group Inseparable has found that only one in three people with commercial health insurance in America are able to access adequate mental health care. This is due to significant barriers in accessing and affording services for mental health and substance use disorders. The report suggests solutions for state policymakers, including changing how health insurance companies make treatment coverage decisions and requiring these companies to use expert nonprofit clinical guidelines for this purpose.
New Report Highlights Mental Health Care Shortages in U.S.
Only one in three people with commercial health insurance and a mental health condition find sufficient care, according to a new report. The study, released by mental health advocacy group Inseparable, highlights significant barriers preventing Americans from accessing affordable mental health and substance use disorder services.
Dr. Benjamin Miller, clinical psychiatrist and report co-author, criticizes the nation’s tendency to treat mental health as less important than physical health. He underscores the difficulties faced by patients in crisis to find help due to barriers erected around care.
The report proposes over a dozen evidence-based solutions for state policymakers and includes state-specific scorecards detailing progress in adopting policies that improve mental health care accessibility and affordability. It also points to a worrying lack of follow-up care post-emergency room or hospital visits, heightening risk of relapse and readmission for patients seeking help for mental health or substance use disorders.
Angela Kimball, Inseparable’s chief advocacy officer and report co-author, emphasizes the crucial role of state-level policy changes in improving mental health care access. She cites Illinois legislators’ efforts to introduce legislation aimed at removing access barriers to mental health and substance use services.
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Maryland Assembly Hears Testimony on Mental Health Insurance Coverage
Committees in both the General Assembly’s chambers are hearing testimonies on a measure to redefine treatment coverage decision-making by Maryland’s health insurance companies. The currently opaque process, known as ‘utilization review’, may be guided by insurance companies rather than clinical standards.
The Senate Finance Committee has reviewed Senate Bill 791, which stipulates insurers use expert nonprofit clinical guidelines to make coverage decisions. David Lloyd, chief policy officer for the nonprofit mental health advocacy organization Inseparable, believes this approach will facilitate care access.
The proposed bill guarantees patients can continue a previously authorized drug and retain drug coverage for 90 days when switching insurers. It also mandates insurers develop a real-time benefits check, enabling prescribers to access electronic health records to view insurance coverage, drug costs, and more.
Lloyd asserts that these measures will expedite the authorization process, which is currently slow and harmful for those in crisis. The electronic health record system is slated to launch by July 2026, if approved.
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