House Republicans are circulating a revised draft of long-stalled mental health legislation.
The controversial bill from Rep. Tim Murphy (R-Pa.) has been cast as the Republican response to mass shootings, but it has long been delayed.
Republicans now are trying to jump-start it as time runs out in an election year.
“We're pretty close, I think, to coming up with some movement in the near future, knowing that the legislative window is closing,” said House Energy and Commerce Chairman Fred Upton (R-Mich.).
Upton has been working with Murphy to smooth over some of the bill’s more controversial provisions, and to bring its costs down.
Those changes have helped address concerns on the Republican side, but Democrats have not yet been brought into the latest talks.
Democrats on the committee have long objected to many aspects of Murphy’s bill. They are pessimistic the divide can be bridged, raising the prospect that Republicans would have to move forward with a party-line committee vote.
Republicans have been focused on cutting the bill’s costs.
The bill would allow Medicaid to cover more care at mental health facilities, but the Congressional Budget Office has put a price tag on the change of $40 to $60 billion over 10 years.
That change is now being rolled back, lawmakers said. One option is to codify into law a scaled down version of the change to Medicaid that the Obama administration included in a regulation in April. It allows Medicaid to cover stays in mental health facilities, but only if they are less than 15 days long.
Another section of the bill causing controversy would allow caregivers and family members to have more information about a mentally ill person’s care by making changes to the Health Insurance Portability and Accountability Act, or HIPAA.
Democrats, as well as some Republicans, had objected to those changes, arguing that they compromise the privacy of mentally ill people.
Rep. Morgan GriffithHoward (Morgan) Morgan GriffithGOP lawmakers press social media giants for data on impacts on children's mental health Lawmakers press federal agencies on scope of SolarWinds attack House Republicans urge Democrats to call hearing with tech CEOs MORE (R-Va.), one of the lawmakers who had concerns about the HIPAA changes, said that the revised bill had not scaled back the changes very much, but that he would not demand a larger shift.
“On the stuff that I was concerned about, they're probably going to leave it substantially as it is,” Griffith said, adding, “if it's going to drag down the bill, I get that, can’t get everything every time.”
Rep. Joe Pitts (R-Pa.), the chairman of the health subcommittee, said that the changes are being well received on the Republican side.
“It's going well; I think it's going to move,” he said, adding that he expects the bill to get a markup in the full committee before Congress goes on recess in mid-July.
Democrats on the committee, though, will be hard to bring on board.
While some revisions are being made to areas of Democratic concern, like the HIPAA changes, the bill still includes major changes to the Substance Abuse and Mental Health Services Administration (SAMHSA), lobbyist sources say.
Murphy has denounced SAMHSA as ignoring the problems of seriously mentally ill people, but Democrats have objected that his changes would essentially gut the agency.
Rep. Frank Pallone (N.J.), the top Democrat on the Energy and Commerce Committee, said that he had not seen the changes yet. “[Upton] is basically talking to Murphy, and we'll see what comes out of it,” he said.
Rep. Gene GreenRaymond (Gene) Eugene GreenBottom line Texas New Members 2019 Two Democrats become first Texas Latinas to serve in Congress MORE (Texas), the top Democrat on the health subcommittee, took a more negative take on Murphy’s bill.
“We have our bill now,” he said, referring to a Democratic alternative introduced in February, which diverged sharply from Murphy’s.
Green said he hopes that House Democrats can gain leverage if the Senate passes its bipartisan mental health bill, legislation similar to the House Democratic bill. It was approved by a Senate panel in March.
“It will give us some tailwind if the Senate passed the bill that was similar to ours,” Green said. “We're not in the majority but I think we would pick up enough Republicans to be able to do something, [that's] not like what Murphy has.”
If the House passed Murphy's bill, substantial negotiations would likely be needed to bring the Senate on board.
The path in the Senate remains unclear, however, amid concerns of igniting a debate over gun control in an election year.
The Senate bill has generally been less controversial, but it is less far-reaching. It does not include the changes to Medicaid or HIPAA in the Murphy bill. This has led some advocates for the mentally ill to argue that the bill does not go far enough.
Murphy’s bill in the House was first introduced in 2013 in response to the mass shooting in Newtown, Conn. Various versions of it have been stalled since then.
Speaker Paul RyanPaul Davis RyanPaul Ryan researched narcissistic personality disorder after Trump win: book Paul Ryan says it's 'really clear' Biden won election: 'It was not rigged. It was not stolen' Democrats fret over Trump-district retirements ahead of midterms MORE (R-Wis.) gave the bill a blitz of attention in December, after a mass shooting in Colorado, pointing to it as the Republican response to gun violence in a series of TV interviews.
But a full committee markup of the bill has been delayed amid the concerns on both sides of the aisle.
Upton is trying to change that.
“We're very close to an accommodation that I think our Republicans would support,” Upton said.
He added that he is “beginning to reach out to the Dem side to see if it really truly could be bipartisan, like I would like it to be.”