House Mental Health Bill Gaining Momentum

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By Nathaniel Weixel

May 25 — Long-stalled House legislation (H.R. 2646) intended to reform the mental health system will be marked up by the full Energy and Commerce Committee in June, a committee spokeswoman confirmed.

The legislation, sponsored by Rep. Tim Murphy (R-Pa.), advanced through the health subcommittee in late 2015 on a narrow party-line vote, but only after a contentious markup that ran more than 10 hours (215 HCDR 215, 11/6/15). Following the markup, frustrated committee Democrats released their own version of the legislation (22 HCDR, 2/3/16).

The bill is still being worked on, and will be marked up as a manager's amendment to the original bill. However, it appears to have momentum going into the full committee markup, as the newer version is much more agreeable to committee Democrats.

Rep. Gene Green (D-Texas), ranking Democrat on the health subcommittee, told Bloomberg BNA that he met with committee Chairman Rep. Fred Upton (R-Mich.) May 24 to discuss the updated version of the bill.

“It looks like it's real promising,” Green said, adding that Upton presented “10 or 12 different changes” that would bring the bill closer to the Democratic version. “Actually legislating is what we're doing. It sounds like there's a way we can do it when we get to the markup. I think by then we'll be able to see where we're at.”

Previous Objections

The provisions of H.R. 2646 that Democrats found most objectionable would have loosened restrictions under the Health Insurance Portability and Accountability Act privacy law regarding the release of a patient's health information, and also would have encouraged states to adopt controversial assisted outpatient treatment (AOT) laws, which allow judges to force people with mental illnesses into treatment. Murphy's bill also would reduce funding for the Substance Abuse and Mental Health Services Administration (SAMHSA), which Democrats said would have weakened the agency.

Earlier this month, Murphy told Bloomberg BNA that he had been working to try to find provisions to compromise on.

“We’ve made a lot of progress trying to address the issues the Democrats were concerned about. I take their concerns seriously, I try and address them, I think their positions are worthy of review,” Murphy said.

The original bill also contained a provision that would have repealed a decades-old policy that limits Medicaid reimbursement for certain inpatient mental health care. Lawmakers in both the House and Senate had hoped to include the provision, but it came with a price tag of $60 billion over 10 years. Murphy said he hoped that a recent final rule from the Centers for Medicare & Medicaid Services allowing Medicaid reimbursement for so-called institutions of mental disease would lower the cost. The manager's amendment is also expected to scale back the provision in order to keep the price down.

To contact the reporter on this story: Nathaniel Weixel in Washington at nweixel@bna.com

To contact the editor responsible for this story: Brian Broderick at bbroderick@bna.com