Lawmakers returned to Lansing last month after adjourning in November last year, and a state association will be advocating for key bills that aim to improve mental health parity in Michigan.
Alan Bolter, associate director at Community Mental Health Association (CMHA) of Michigan, discussed CMHA’s 2024 legislative priorities with State of Reform.
“We are more on the offensive versus the defensive this year, so we’re pushing a number of things,” Bolter said.
CMHA’s top priority will be mental health parity bills. Senate Bill 27 would ensure behavioral health parity laws are meaningfully applied at the state level. It would codify the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008—a federal law that generally prevents group health plans and insurance issuers that provide mental health or substance use disorder (SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits—in the state.
“It takes the federal law and puts it into state statute,” Bolter said. “We don’t have those protections in state law. It’s more symbolic than anything, but it sets a baseline for the issue.”
SB 27 passed the Senate last year and is currently in the House. CMHA also supports House Bill 4707, which aims to require health insurers to cover all medically-necessary mental health and SUD treatments. It would require coverage for intermediate and outpatient care for SUD.
“This bill actually stands on the federal mental health parity law. If SB 27 passes, HB 4707 would expand it a decent amount. There are two main areas it expands; one is medical necessity where the bill would require an actual mental health or SUD professional to do the analysis on what kind of coverage they need. It would also look at scientific criteria along with the professional criteria and say, ‘For this diagnosis, this is the treatment plan you need.’”
— Bolter
HB 4707 would also address in-network versus out-of-network care coverage, Bolter said.
“If they have to go outside their network, this bill means you can’t charge more for out-of-network coverage than for in-network coverage,” he said. “This bill, in reality, will not impact people who receive services throughout our community; we represent the public mental health system. This bill won’t impact those folks, but it will impact anyone who has commercial-based insurance. That’s the majority of people who have a mental health disorder or SUD.”
CMHA will also be advocating for bills that increase access to telemedicine. HBs 4131, 4213, 4579, and 4580 would provide payment parity for telehealth services and implement limitations on health plans’ ability to dictate site-specific visit requirements. They support providers’ ability to serve patients and protect in-person visits vital to health outcomes.
“The most important change these bills would make is that telehealth services would have to be reimbursed at the same level as in-person care. The telehealth package doesn’t impact our system much, but it would be helpful on the employer-based side. It expands coverage, making it easier for people to get services.”
— Bolter
The telehealth bills passed the House last year and await votes in the Senate. CMHA also supports HBs 5184 and 5185, which would provide licensure requirements for licensed clinical social workers.
“The other big issue we’re hoping to see movement on would change the social worker licensure procedures where they would essentially eliminate the exam required for social workers as part of their requirement to be fully licensed in Michigan,” Bolter said. “The more experience one has, the harder it is for a social worker to pass the licensure exam. This bill would require some additional supervision and oversight to go with that process. Social workers are the largest [group of] clinicians in the public health system. With our members, workforce is one of the biggest issues they have in finding enough workers.”
As a retired nurse and mental health professional who worked in rural counties in Northern Michigan, I am aware of the desperate need for people to have affordable access to mental health services and also for healthcare that fits the needs of those who are homebound and unable to afford transportation to get their healthcare needs met. Like the rest of the country, we do not the healthcare workforce that we need. Please pass HBs 5184 and 5185 to help mediate this critical shortage of social workers. I strongly encourage the passing of SB27, and HB4131, HB4213, HB5479, HB4580. Thank you. Ruth Pilon