Bipartisan mental health bill advances in Senate

Bipartisan mental health bill advances in Senate
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The Senate Health Committee on Wednesday advanced a bipartisan mental health bill to the full Senate as part of a difficult push to achieve mental health reform in an election year. 

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The bill, a narrow consensus document, passed the committee unanimously on a voice vote. More thorny issues are expected to be dealt with later on the Senate floor.

Senate Health, Education, Labor and Pensions Committee Chairman Lamar AlexanderAndrew (Lamar) Lamar AlexanderDemocrats hit Scalia over LGBTQ rights Here are the lawmakers who aren't seeking reelection in 2020 EXCLUSIVE: Swing-state voters oppose 'surprise' medical bill legislation, Trump pollster warns MORE (R-Tenn.) said the underlying bill is ready to be considered whenever Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellOvernight Energy: California, 23 other states sue Trump over vehicle emissions rule | Climate strike protests hit cities across globe | Interior watchdog expands scope of FOIA investigation | Dems accuse officials of burying climate reports Hillicon Valley: Lawmakers say Zuckerberg to 'cooperate' on antitrust probes | Dems see victory after McConnell backs election security funds | Twitter takes down fake pro-Saudi accounts Liberal super PAC launches browser extension replacing 'Mitch McConnell' with 'Moscow Mitch' MORE (R-Ky.) chooses. 

“Many of us, on both sides of the political aisle, believe there is a mental health crisis, and that's why so many of us are now focused on finding ways to address it,” said Alexander. 

The Senate bill seeks to improve coordination of mental health programs by granting new powers to an assistant secretary in the Department of Health and Human Services and sets up a new office to encourage the adoption of evidence-based programs. The legislation also authorizes grants for topics like integrating physical and mental health services, though the amount of the funding will depend on the appropriations process. It also seeks to push insurance companies to provide better mental health coverage through what is known as “parity.”

Some advocates have criticized the bill for being far too narrow, particularly in the area of helping people with serious mental illnesses. 

Broader provisions are expected to be added to the bill on the floor, however. An area of particular focus is removing a restriction on Medicaid paying for care at certain mental health facilities, known as the “IMD [Institutions for Mental Diseases] exclusion,” which is seen as a major barrier to care access. 

Sens. Susan CollinsSusan Margaret CollinsTrump judicial picks face rare GOP opposition GOP signals unease with Barr's gun plan Sinema touts bipartisan record as Arizona Democrats plan censure vote MORE (R-Maine) and Chris MurphyChristopher (Chris) Scott MurphyDemocrats hit Scalia over LGBTQ rights GOP signals unease with Barr's gun plan Trump administration floats background check proposal to Senate GOP MORE (D-Conn.) both stressed the provision on Wednesday.

“There are Republicans who support that,” Alexander told reporters. “You heard Sen. Collins comment on it, so I think there’s bipartisan support for it.”

He said the provision could be offered as an amendment on the floor.

Murphy said he has already begun talks with the Senate Finance Committee to find a way to pay for the change. The Congressional Budget Office (CBO) has scored the change at $40 billion to $60 billion over 10 years, a daunting sum. But Murphy said CBO is revisiting that score after being given new information by House lawmakers. 

Other costly provisions could be added later on the Senate floor. Sen. Sheldon WhitehouseSheldon WhitehouseThe Hill's Morning Report - Trump eyes narrowly focused response to Iran attacks Kavanaugh impeachment push hits Capitol buzz saw Senate GOP pledges to oppose any efforts to 'pack' Supreme Court MORE (D-R.I.), for example, is looking to fund a $250 million pilot program for mental health providers to be eligible for “meaningful use” financial incentive payments for adopting electronic health records. 

Sen. Roy BluntRoy Dean BluntClarence Thomas, Joe Manchin, Rudy Giuliani among guests at second state visit under Trump McConnell support for election security funds leaves Dems declaring victory Paul objection snags confirmation of former McConnell staffer MORE (R-Mo.) is also looking to expand a program setting up urgent care mental health clinics from eight states to 24 states. 

Legislation from Sen. John CornynJohn CornynTrump judicial picks face rare GOP opposition Zuckerberg woos Washington critics during visit Paul objection snags confirmation of former McConnell staffer MORE (R-Texas), which has been controversial because of its gun provisions, could also be offered as an amendment, Alexander said, adding that Cornyn could also decide to offer his bill separately at a different time. “That’ll be up to him,” Alexander said. 

Some advocates for people with serious mental illnesses have been disappointed that the Senate bill leaves out some provisions that are in a House bill from Rep. Tim Murphy (R-Pa.).

Namely, the Senate bill does not go as far in changing a health privacy law to allow information to be shared with caregivers, and does not provide financial incentives for states to adopt assisted outpatient treatment laws that cover instances in which a judge can order a mentally ill person to follow a treatment plan. 

The House bill became mired in committee amid disputes over those controversial provisions. 

Senators said they hope their work pushes the House along and that Sens. Murphy and Bill Cassidy (R-La.), two of the leaders of the upper chamber’s effort, can serve as an example of bridging partisan differences. 

“I think [the Senate bill] does diverge [with the House bill], but Sen. Murphy and Sen. Cassidy started out with much of the House bill, and they worked with their colleagues to come up with a bipartisan approach that's a consensus,” Alexander said. “That might help the House come to a conclusion.”