December 5, 2022

The following information from Politico summarizes ongoing end-of-year topics being considered by federal lawmakers to include many issues of import to NYS Council members including:  integration of primary care and mental health, boosting the behavioral health workforce,  ensuring parity in mental and other health coverage, telehealth in Medicaid and Medicare, and an addiction package.   (For more on this last item, see second article, dated 12/2 from Axios): 

Politico, 12/5 – MENTAL HEALTH HOPES — With another week of deal-making on the Hill ahead, one health issue is increasingly being discussed: mental health provisions.

Republicans and Democrats alike told Ben and your host that mental health is a target to be included in an omnibus deal — and that conversations were ongoing last week.

Sen. Bill Cassidy (R-La.) told Pulse he looks to get his Mental Health Reauthorization Act of 2022 included in the package, and Rep. Paul Tonko (D-N.Y.) told Axios he was confident an addiction treatment package would be added as well.

Several others, across parties, chambers and committees, have generally emphasized the need to address mental health in a year-end bill. Sen. Ron Wyden (D-Ore.) told Ben last week that his health staff is working on a mental health policy and they might have more details about the measures to share soon.

Special interest groups also have asked leaders on the Hill to include a number of mental health provisions.

Several provider groups, including the American Academy of Pediatrics, the American College of Physicians and the American Psychiatric Association, sent a letter Friday to congressional leaders , asking for legislation that promotes the integration of primary care and mental health, boosts the behavioral health workforce and ensures parity in mental and other health coverage.

And the American Hospital Association sent a recent letter to Congress, addressing mental health, asking leaders to strengthen the care workforce, loosen regulations for psychiatric facilities and change payment policies around behavioral health.

Some of those asks are included in legislation introduced earlier this year — places congressional aides suggested looking to see where the conversation could go in the coming weeks.

Earlier this year, senators introduced three bipartisan discussion drafts of legislation to tackle mental health, which suggested ways telehealth, Medicare and Medicaid could be leveraged in the future, among other things.

And one House bill, the Restoring Hope for Mental Health and Well-Being Act of 2022, overwhelmingly passed, though the Senate has yet to vote on it.

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Year-end package could increase access to addiction treatment

A bipartisan bill to increase access to treatment for opioid addiction has a good chance of being rolled into a year-end package during the lame-duck session, congressional aides tell Axios.

Why it matters: Advocates point to federal data showing only one in 10 people with opioid use disorder receive medication for it.

How it works: The bill would remove a requirement that health care providers get a special waiver from the Drug Enforcement Administration before they can prescribe buprenorphine, an addiction treatment that reduces the risk of future overdoses.

What they’re saying: Rep. Paul Tonko (D-N.Y.), one of the lead sponsors of the bill, told Axios he is “very confident” it will make the omnibus. “Leadership is working hard to get it done,” he said, calling the bill a “lifesaver.”

• Nearly 200 organizations sent a letter to Congress this week urging its passage, including the National Association of Counties, the American Medical Association and the National Sheriffs’ Association.

The path forward: Backers say they have not encountered a large amount of opposition, but there is still a lot of uncertainty around how big the end-of-year package will be and what will make it in.

• There is at least some opposition from certain House Republicans, including members who are doctors, like Indiana Rep. Larry Bucshon. Bucshon said earlier this year that the bill is “making it easier to prescribe a medication known to be highly diverted and misused.”
• Some doctors remain unwilling to prescribe buprenorphine for use at home without supervision, and there’s also concern about a lack of data about the drug’s effectiveness in those who misuse multiple substances.

• At least at the moment, though, backers do not think the opposition will be enough to stop it from making it into the bill.
• The list of cosponsors in the Senate includes members from across the ideological spectrum, including Maggie Hassan (D-N.H.), Bernie Sanders (I-Vt.), Rand Paul (R-Ky.) and Marsha Blackburn (R-Tenn.).

In the House, Chris Krepich, a spokesman for House Energy and Commerce Committee ranking Republican Cathy McMorris Rodgers, said it is a priority for her to get the House’s mental health package, which includes the bill language, passed and signed into law in this Congress.

• The package got over 400 votes in the House earlier this year.