Beltway Update is an occasional column keeping you up to date on timely Congressional and administrative action on mental and behavioral health bills and policy in Washington, DC.

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Mental health care and substance use may finally have achieved parity with primary care and specialty medicine – at least in terms of congressional interest. In February alone, there have been five mental and behavioral health hearings between the four committees with jurisdiction over health. Those who have been tracking mental health for a while will tell you this is an unprecedented focus on an often-overlooked subject.

So why has this subject gotten a lot of attention recently? The COVID-19 pandemic has exacerbated the need for mental health and substance use services among American adults and youth. Additionally, the impending July 2022 launch of “988” as the three-digit phone number for the National Suicide Prevention Lifeline has garnered state and Congressional attention. What’s not as clear is what this level of attention may mean for federal behavioral health policy and funding. Let’s break it down further.

The Senate Finance Committee kicked off the process last fall by soliciting stakeholder input on priorities for a behavioral health package and received 550 replies. The committee held two hearings in February focusing on youth mental health, prompted in part by Surgeon General Vivek Murthy’s declaration of a crisis. The first panel featured the Surgeon General, and the second was a panel of other witnesses.

Last fall, there was an additional request for information tied to the Health, Education, Labor & Pensions (HELP) Committee’s forthcoming work on a group of Substance Abuse and Mental Health Services Administration (SAMHSA) programs that are up for reauthorization this year. The HELP Committee held a hearing on the growing mental health and substance use disorder crisis earlier in February.

On the House side, the Ways and Means Committee held a hearing on America’s mental health crisis in early February, as did the Energy & Commerce Subcommittee on Oversight and Investigations.

On the Senate side, the Finance Committee process has split work into five focus areas, including:

  • Strengthening the workforce
  • Increasing integration, coordination and access to care
  • Ensuring parity between behavioral and physical health care
  • Furthering the use of telehealth
  • Improving access to behavioral health care for children and young people

Finance plans to have a draft bill together by the end of April and will mark it up in June. They will likely pair the Finance bill with the HELP Committee’s reauthorizations package for SAMHSA and get the bill to the Senate floor in mid-summer. Given the upcoming midterm elections, it’s fair to expect most regular congressional action to shut down from then until mid-November. After the two House committees finish their mental and behavioral health packages, they will likely be joined with the Senate provisions in an end-of-year spending bill. 

While this is unprecedented Congressional focus on mental health, it’s worth remembering that bipartisan work on these issues requires compromise. All new spending will need to be offset by finding savings elsewhere in the health space. This will likely be among the most challenging pieces to find agreement. 

Despite the long road ahead, there seems to be genuine bipartisan, bicameral interest in creating new mental health and substance use policies. From start to finish, it may take almost a year and a half to see if something comes together, but the level of bipartisan focus already displayed is a promising sign.

Sarah Corcoran is vice president of government relations at Guide Consulting Services (GCS), a government relations consulting practice based in Washington, DC. GCS represents mental health providers, technology companies, patient advocacy organizations and state mental health agencies before Congress and the administration. A complete list of GCS clients can be found here.

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