The mental health care quandary

The ideas and innovators shaping health care

Jul 26, 2023 View in browser   By Ben Leonard, Erin Schumaker and Evan Peng WASHINGTON WATCH Tanden blamed insurers for the lack of access to mental health care. | Tom Williams/CQ Roll Call/Newscom The Biden administration joined the vigorous debate this week about why millions of Americans who have a mental illness still aren’t getting help — and put the blame squarely on health insurers. But the insurers say the real reason is a dearth of clinicians trained to treat people for conditions like anxiety and depression. Biden’s case: In introducing new rules for insurers, White House domestic policy adviser Neera Tanden argued that insurers deliberately make it hard for their subscribers to access mental health care from providers who take their insurance, forcing patients to pay out of pocket. She said insurers do this by failing to establish adequate networks of mental health providers, forcing patients to seek treatment out of network. Additionally, the administration accuses insurers of often requiring clinicians to obtain prior authorization for treatments, or otherwise putting up roadblocks for patients seeking mental health care. The American Medical Association, the leading professional society for doctors, backs the White House’s assessment. The administration’s proposed rules would require insurers to set up networks and coverage-decision mechanisms for mental health care that are equivalent to those for physical health. Insurers respond: Kristine Grow, spokesperson for AHIP, the lobbying organization for health insurers, acknowledged the difficulty some patients have in obtaining mental health care but said the problem is rooted in the clinician shortage. The insurers cite data from the health research group KFF that  47 percent of Americans — 158 million people — live in a mental health workforce shortage area, as defined by the Department of Health and Human Services. That makes it hard to maintain robust networks of providers, she added. Grow said insurers are nonetheless working hard to expand their networks and using tools like telehealth to reach patients in care deserts. She cited a 108 percent increase in claims for behavioral health from 2007 to 2017, as detailed in a report from FAIR Health, a nonprofit that examines health insurance claims, as evidence that those efforts are paying off. Republicans have the insurers’ backs. House Education and the Workforce Chair Virginia Foxx (R-N.C.) said the Biden rules were overly burdensome and meddled inappropriately in the insurance business. She said the rules would backfire by imposing “hundreds of millions of dollars in additional costs on businesses, increase premiums, and run the risk of encouraging plans to create more barriers to medical care.” What’s next? The administration hasn’t yet released the text of the regulations. Once it does, they’ll be open for 60 days of public comment, after which they could be finalized.   JOIN 7/27 FOR A TALK ON WOMEN LEADERS IN THE NEW WORKPLACE: In the wake of the pandemic, U.S. lawmakers saw a unique opportunity to address the current childcare system, which has become increasingly unaffordable for millions of Americans, but the initial proposals went nowhere. With the launch of the Congressional Bipartisan Affordable Childcare Caucus in May, there may be a path to make childcare more affordable. Join Women Rule on July 27 to dive into this timely topic and more with featured speakers Rep. Nancy Mace (R-S.C.), Rep. Ro Khanna (D-Calif.) and Reshma Saujani, Founder & CEO of Moms First and Founder of Girls Who Code. REGISTER HERE.     WELCOME TO FUTURE PULSE Nationals Stadium, Washington, D.C. | Ben Leonard This is where we explore the ideas and innovators shaping health care. Cooking contest: The New York City Public Housing Authority announced the "Induction Stove Challenge" Monday. The contest asks companies to design an induction stove that won’t require an electrical upgrade to replace a gas range. The housing authority will buy at least 10,000 stoves from the winner in an effort to combat climate change and encourage healthier cooking. Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, host Megan Messerly talks with Ben about the White House's proposal to regulate health insurers' mental health care coverge practices. Listen to today’s Pulse Check podcast DANGER ZONE Warren wants answers about the DOD's talks with Google. | Getty Images Sen. Elizabeth Warren (D-Mass.) is investigating Google's alleged efforts to gain exclusive access to the Department of Defense's tissue samples housed at the department's Joint Pathology Center — a cache Google told the military was "on par with the Human Genome Project." On Tuesday, Warren, who chairs the Senate Armed Services Personnel Subcommittee, sent letters to the Secretary of Defense and Google's CEO demanding information about dealings between the tech giant and the DOD. Warren's investigation was spurred by a ProPublica report last December, which found that: — Google launched a campaign to gain exclusive access to the Joint Pathology Center collection. — In exchange for exclusive access, Google offered to digitize the collection. Turning the slides into an archive could give the company an edge in developing profitable diagnostic tools and treatments. — At least a dozen DOD staff members pushed back on the initiative, due to health data privacy concerns and worries about the risk of allowing a corporation to use government data to develop AI tools. — Google was not ultimately selected to help digitize the pathology archive. The contract went to Johns Hopkins University. — After being passed over, Google launched a lobbying campaign in Congress and the House Armed Services Committee included language in a report accompanying the National Defense Authorization Act in 2023 critical of DOD’s modernization efforts. Google did not immediately respond to POLITICO's request for comment, but a blog post the company released in response to ProPublica's December investigation addressed the dynamic: "We’re obviously disappointed we weren’t given the opportunity to compete for this important project, but we continue to this day to offer our help and collaboration for this and other digitization initiatives." Why it matters: Warren argues that while the deal ultimately fell through, the report raises questions about transparency as well as ethical and legal concerns about the relationship between Google and the DOD. "The Department of Defense’s Joint Pathology Center has millions of tissue samples from service members and veterans that are meant to support the public good — but Google came dangerously close to landing an exclusive monopoly on these samples and the right to charge DoD for access to this data," Warren said in a statement. "Google and the DoD owe the American people answers for these shady dealings, which could violate the privacy of our service members and veterans." The DOD declined to comment. What's next: Warren requested responses to the questions posed in her letters by Aug. 8.   YOUR TICKET INSIDE THE GOLDEN STATE POLITICAL ARENA: California Playbook delivers the latest intel, buzzy scoops and exclusive coverage from Sacramento and Los Angeles to Silicon Valley and across the state. Don't miss out on the daily must-read for political aficionados and professionals with an outsized interest in California politics, policy and power. Subscribe today.     TECH MAZE Biden endorsed legislation aimed at combating mental health issues linked to social media. | Manuel Balce Ceneta/AP Photo President Joe Biden called on the Senate to pass kids online safety and privacy bills that a Senate committee is planning to consider tomorrow. “We’re taking steps to address the harm that social media is doing to our kids,” Biden said during Tuesday remarks on expanding access to mental health care. “We’ve got to hold these platforms accountable for the national experiment they’re conducting on our children for profit.” The Senate Commerce Committee will vote on two bipartisan bills — the Kids Online Safety Act and the Children and Teens’ Online Privacy Protection Act — which are expected to advance, as they did last year, POLITICO's Rebecca Kern reports. ‘Pass it,’ already: “Later this week senators will debate legislation to protect kids’ privacy online, which I’ve been calling for for two years,” Biden said. “It matters. Pass it, pass it, pass it, pass it, pass it,” he chanted. The remarks reflected some of the strongest comments from the president on the bills. Biden also called on Congress to pass stronger kids online safety and privacy bills in his past two State of the Union addresses. Second time’s a charm?: KOSA and COPPA 2.0 advanced out of the committee last year, but failed to get a Senate floor vote. KOSA would require tech companies to build kids’ safety features into their products and COPPA 2.0 would extend existing online privacy protections for younger teens up to age 16. Kids’ safety bills have been listed as a priority for year-end legislation by Senate Majority Leader Chuck Schumer (D-N.Y.).   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker Evan Peng @thepngfile   Follow us

To change your alert settings, please log in at https://www.politico.com/_login?base=https%3A%2F%2Fwww.politico.com/settings This email was sent to rouf@idiot.cloudns.cc by: POLITICO, LLC 1000 Wilson Blvd. Arlington, VA, 22209, USA Please click here and follow the steps to unsubscribe.