Republican leaders are turning to mental health reform in response to a pair of mass shootings in recent days, putting new focus on getting a bill passed despite concerns on both sides of the aisle and the divisiveness of the gun debate.
After mass shootings in Colorado and California, Speaker Paul RyanPaul RyanSanders set for clash with Trump’s budget pick Is healthcare law really going into a ‘death spiral’? Trump hosts Hill leaders for ice breaker MORE (R-Wis.) cited the mental health reform bill from Rep. Tim Murphy (R-Pa.) throughout the week when questioned about the Republican response to gun violence.
“I don’t want to keep saying the same thing over and over,” Ryan said after the fourth question in a row about actions to take about mass shootings. “But one of the things we’ve noticed: There are mental health issues here.”
In holding up the Murphy mental health bill as a response to the shootings, Ryan is raising expectations that it will actually pass. “We want to see this process all the way through,” Ryan told reporters on Tuesday.
“We’re really serious about our mental health legislation,” he added on Thursday.
But Republican leaders have gone down this road before. After the 2012 shooting in Newtown, Conn., House leaders also cited mental health reform as part of the solution, but the Murphy bill never ended up getting off the ground.
The Energy and Commerce health subcommittee advanced the bill last month, but consideration by the full committee has been put off while objections on both sides of the aisle are worked out.
Republican leadership has acknowledged the problems. On Monday, asked about a potential floor vote, House Majority Leader Kevin McCarthy (R-Calif.) noted that Murphy is hammering out language.
“He’s working on the bill itself and after the subcommittee [markup] some people brought up some different issues,” McCarthy said.
Murphy’s bill includes a range of provisions aimed at helping people with serious mental illness, such as creating a new assistant secretary for mental health and seeking to increase the number of psychiatric hospital beds available by lifting restrictions on Medicaid paying for certain care. The bill does not deal directly with guns.
However, the divisive politics of gun control have long surrounded the legislation, and many Democrats are irked by Republicans pivoting to mental health instead of dealing with gun control.
"Of course I'm happy to work on anything dealing with mental health," Senate Democratic Leader Harry Reid (Nev.) said this week. "But it seems to me any time, and that's often now, we have one of these horrible murders take place, the Republicans go, "Let's do something about mental health."
And gun politics could be further injected into the mental health debate through a bill from Sen. John Cornyn (R-Texas), the Senate’s No. 2 Republican. Cornyn’s bill includes many aspects that Democrats could support, such as increasing treatment for mentally ill people facing incarceration.
But liberal groups have also argued that the bill would make it easier for mentally ill people to get guns, in part by strengthening requirements to make sure there is a full judicial hearing before someone can be banned from buying guns because of mental illness. The National Rifle Association endorses Cornyn’s bill.
Cornyn told reporters last month that his bill would get a hearing in the Judiciary Committee in January. But there is also talk of Cornyn’s bill being combined with a bipartisan measure, similar to the House legislation, from Sens. Chris Murphy (D-Conn.) and Bill Cassidy (R-La.).
“It looks to me like the Judiciary Committee may be the engine that pulls the train, but obviously we'll all be working together,” Cornyn said last month.
Meanwhile, on the House side, despite Republican leaders pushing for Tim Murphy’s bill, there are still objections from some Republican lawmakers.
Some, such as Rep. Bill Flores (R-Texas), chairman of the conservative Republican Study Committee, have objected to the bill’s cost.
Last month, the Congressional Budget Office (CBO) projected the bill’s price tag at $46 billion to $66 billion over 10 years, a daunting sum. Most of the cost comes from one provision, which allows Medicaid to cover more care at mental health facilities, and lawmakers are working to bring the number down. The provision has already been scaled back since the CBO projection.
Rep. Morgan GriffithMorgan GriffithUse Holman Rule on federal employees that work full-time for union Adopting old-school rule would show House is serious about reform ObamaCare's risk corridor corruption never ends MORE (R-Va.) has been meeting with a group of lawmakers in both parties who are lawyers to try to work out a change to the bill’s language on a health privacy law known as the Health Insurance Portability and Accountability Act (HIPAA). Murphy’s bill would ease the restrictions with the aim of giving caregivers more information.
But others warn that the changes, as they currently stand, would lower privacy protections for mentally ill people.
Democrats on the Energy and Commerce Committee have been more vocal in their objections. They say they are committed to reforming mental health but that Murphy has been unwilling to compromise.
They warn that the bill could cut substance abuse treatment funding and gut the Substance Abuse and Mental Health Services Administration, which Republicans deny.
Rep. Gene GreenGene GreenLawmakers worry ObamaCare fight could suck air from other priorities Midwest Dems feel left out in cold Overnight Healthcare: Hospitals plot attack against ObamaCare repeal MORE (D-Texas), the health subcommittee’s top Democrat, said his party is still hoping for a compromise after months of trying.
Asked about the attention from Republican leaders on the bill since the shootings, Green countered: “Well, we'll be glad to invite them in and they can do some of the discussion on what we need to put in the bill.”
Republicans, in turn, put the blame on Democrats.
“I'm trying to get bipartisan support, and they're resisting,” said Rep. Joe Pitts (R-Pa.), chairman of the health subcommittee. “If they don't support it, you know, eventually I think we'll just move our version.”