Farah Siddiqi, Producer
Wednesday, February 28, 2024
A House bill aimed at increasing access to mental health care in Michigan could go to a vote on the House floor at any time.
Rep. Felicia Brabec, D-Pittsfield, a clinical psychologist, introduced the bill in 2023 and said it prioritizes treatment recommendations for mental health and substance use patients, instead of allowing only insurance companies to make decisions for an individual's care.
Brabec pointed out the measure would enable insurance companies to find an out-of-network option if an in-network option is unavailable, without extra cost to the patient.
"The insurance companies have their own proprietary criteria when they are making the decisions about should people have access to services or not," Brabec noted. "I think that they should use the same critical criteria that we do. Like if a doctor said, 'This is what's necessary for a client,' then that should be attended to."
Blue Cross Blue Shield of Michigan has spent more than $75 million in lobbying efforts over the last two decades. In an emailed statement, the company said it opposes the legislation but remains "committed to working with policymakers to find innovative solutions to address the hurdles Michiganders face to get the behavioral health care they need and improve overall health outcomes." The company also said it is working to expand crisis services and recruit providers in multiple areas of the state.
Allyson Haupt, who has a son on the autism spectrum, said she struggled to get his care approved by her insurance company for him. She added following a crisis and hospitalization, she got a bill for $147,000.
"They (health care providers) felt he needed to stay in there longer," Haupt recounted. "The hospital received a call from our insurance carrier, saying, 'No, we don't think he needs inpatient care,' when they're not aware of all of his behaviors and that sort of thing. And so, they asked for him to be discharged."
Haupt noted she eventually got insurance to foot the bill. Advocates of the measure said it would reduce costly emergency room and hospital visits, thereby lowering the overall cost of care and helping get people treatment more efficiently. Other states adopting similar legislation have seen no large premium increases, and a decrease in coverage denials for mental health care.
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