Montana doubles mental health-care requirements

Montana lawmakers have doubled up on federal mental health-coverage requirements as the future of health reform waits for debate in Washington, D.C.

Last week, Montana Gov. Steve Bullock held a ceremonial bill signing for legislation that requires insurance companies to cover mental health care the same way physical health care is covered.

Bullock said the Montana Mental Health Parity Act will leverage the private insurance market to help integrate behavioral and physical health care in Montana.

“This groundbreaking legislation will help to bolster a full continuum of services for individuals with untreated mental health needs so that they can seek the care they need and deserve,” Bullock said.

The act mandates equal treatment for physical health, mental health conditions, and substance use disorders in insurance plans. It also provides a state-level accountability and customer assistance resource for mental health and substance use care coverage.

Bill Sponsor Rep. Laurie Bishop, D-Livingston, joined Gov. Bullock at the ceremonial bill signing in Helena on June 2.

“This legislation comes at a critical time as we watch what is happening at the federal level,” Bishop said.

The new Montana law reflects a practice required by the Affordable Care Act. However, the national GOP effort to repeal and replace the act passed the U.S. House in early May.

A Congressional Budget Office analysis estimated the health-reform bill would reduce the federal deficit over the 2017-2026 period by $119 billion. Simultaneously, it would increase the number of uninsured people by 23 million in 2026, according to the report.

The bill also allows states the flexibility to create waivers for parity rules.

U.S. Senate Republicans rejected the House bill but have struggled to come to an agreement on their own version of reform.

According to the Associated Press, Senate Republicans were presented with legislative options at a meeting Tuesday, June 6, with the goal of making decisions on what’s in and what’s out of their bill. Still up for Senate debate is how to phase-out the Medicaid expansion in the Affordable Care Act.

BEFORE THE Montana Medicaid expansion, limited state dollars were used to provide mental health services through the state’s Mental Health Services Plan.

The plan extended to Montanans with a serious and disabling mental illness who couldn’t afford insurance or qualify for Medicaid.

Montana’s Medicaid expansion brought coverage to 77,154 people in the state as of May, according to the state’s health department. Of those people, more than 7,800 new enrollees live in Flathead County.

Montana’s new parity law had split support as it made its way through the 2017 legislative session, at times struggling to stay alive. In a final Senate Public Health Welfare and Safety vote, the bill passed on a 32-18 vote.

Sen. Bob Keenan, R-Bigfork, was one of the “no” votes.

“The bill was well-intentioned, it was a compassionate bill, but the devil’s in the details,” Keenan said.

He said that he’s concerned there will be unforeseen costs attached to the law, for businesses and individual counties.

Established federal law exempts small employers from parity requirements. The state’s bill does not. That means it could put some existing plans in a conflict situation between federal law compliance and Montana’s parity act, according to the fiscal note.

The bill’s fiscal note also states there would be a cost to local governments not currently offering these benefits. However, according to the note, it’s assumed that local governments already offer “this services and therefore, there would be no fiscal impact.”

In a press release from the Governor’s office, state officials said the integration of physical and mental health care has been proven to reduce costs and improve care.

Bishop said the state’s new legislation, which she sponsored, will safeguard mental health benefits for Montana.

“These very important protections for mental health care are all the more relevant as we continue to define our own solution here in Montana,” she said.

Reporter Katheryn Houghton may be reached at 758-4436 or by email at khoughton@dailyinterlake.com.