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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Virginia is bolstering mental health care during and beyond Mental Health Month.

Since the pandemic, the need for behavioral health services has grown considerably, especially among young people. Social media and pandemic-era isolation contributed to an ongoing youth mental health crisis.

Bruce Cruser, executive director of Mental Health Virginia, said a spillover effect of the pandemic is the reduced stigma around mental health.

"You have more people willing to talk about their mental illness or the fact that they're not feeling well," Cruser observed. "It's good that more people are open about it and more people are asking for help when they need it. I mean, that's a good thing. The bad thing is that there's so much need."

The state has made progress in funding mental health services. Virginia's new budget provides an almost $2.5 million increase in children's mental health funding to $15 million for 2025 and 2026, but many other funding pots have been reduced, redirected or eliminated.

While the state is broadening the services provided, barriers to accessing them remain. Beyond existing stigma in certain communities, Cruser pointed out there are many reasons people are unable to get the help they need.

"For some people it's cost, because they still might not have insurance or know about available insurance options," Cruser acknowledged. "But even with insurance, there can be high copays, etc. But another one is availability of the service."

The federal Health Resources and Services Administration designated all of Virginia under a mental health professional shortage. Other reports show the state has few areas where youth behavioral health services are close to sufficient.

Georgia is taking on its mental-health care challenges head-on through new legislation.

One bill is aimed at increasing the number of providers in the state. Senate Bill 480 offers loan repayment assistance to mental-health care professionals who choose to work in underserved areas.

Rep. Sharon Cooper, R-Marietta, highlighted the state's access landscape, noting that of its 18 public health districts, 12 are located in rural areas. She said the goal is to ensure equitable access to mental-health services for all.

"Georgia is terribly short of psychiatrists, psychologists, social workers, marriage and family providers, all levels of people that deal with various aspects of mental illness," said Cooper.

According to the Rural Information hub, most of Georgia struggles with having enough mental-health providers. The data shows out of 159 counties, only six have no shortage, and two only have shortages in parts of the county.

Cooper elaborated on the multifaceted challenges Georgia faces in mental-health care, citing historical underinvestment and rapid population growth as contributing factors to the current shortage. She described the evolution of mental-health care policy in Georgia, including previous legislative efforts to promote parity between mental and physical health care.

"We are trying to make up for mistakes of the past and trying to do what's right for mentally ill people and to put their illness on parity with anybody that would have a gallbladder or heart disease," Cooper added.

Cooper pointed out that in this past legislative session, 19 bills were signed to help increase the state's ability to care for mental- and behavioral-health needs. Other legislation includes SB 373, which helps provide expedited licenses to marriage and family therapists.


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New York's 2025 budget improves access to mental-health services.

Budget legislation stipulates commercial insurers have to pay rates similar to Medicaid for in- and-out-of-network behavioral health services.

While many New York adults can access care, younger people can't because of insurance coverage.

Matthew Shapiro - senior director of government affairs for the National Alliance on Mental Illness-New York State - said people are glad this broadens access to often limited mental health services.

"We hear from people all the time that they can't access care, they can't find a psychiatrist, they can't find a social worker, they can't find someone who'll prescribe medication," said Shapiro. "It can be very, very difficult, especially in parts of Upstate New York where these services just aren't readily available."

Some insurance companies pushed back, saying it would raise customers' rates. Shapiro noted that this will hopefully resolve long-standing issues in obtaining mental-health care.

A state Attorney General's office report finds 86% of the listed, in-network mental-health providers were either unreachable, not in-network, or not accepting new patients.

The budget allocates millions of dollars to other programs that establish new inpatient psychiatric beds statewide, and increase mental health support for first responders.

But, Shapiro noted that other insurance companies' barriers prevent New Yorkers from getting the best mental-health care they can.

"It's so important those people get the medications their doctor believes are best for them, and their individual set of symptoms as quickly as possible," said Shapiro. "So, eliminating things like fail-first procedures and what they call step-up procedures."

He added that these policies can significantly set back a person's recovery.

A 2024 survey finds 1 in 5 adults required to fail first had to visit the emergency room or be admitted to a hospital as a result of the policy.




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