Patrick Kennedy’s mental health parity pitch

The ideas and innovators shaping health care

Jan 24, 2024 View in browser   By Ruth Reader, Daniel Payne and Erin Schumaker WORKFORCE Kennedy | Courtesy of Patrick Kennedy Patrick Kennedy sees a path to his longtime goal: parity in insurance coverage between mental and physical health care. How so? The former representative from Rhode Island listened when insurers complained last year that the path to parity is blocked by workforce shortages. He wants to convene labor unions, insurers and the government to come up with a way to boost the mental health workforce. “What I’ve really wanted to do is create an AFL-CIO for addiction,” he said, adding that Congress can help with “an infrastructure bill” for mental health. He also sees a bigger role for community mental health centers, first funded under the last piece of legislation his uncle, President John F. Kennedy, signed before his assassination. He wants to integrate community behavioral health centers with physical health centers to better serve Americans with mental health issues. State of play: Kennedy wrote the 2008 Mental Health Parity and Addiction Equity Act that ordered insurers to cover mental health on the same terms as physical health. The Biden administration last year accused the insurance industry of skirting the law by providing inadequate networks of mental health providers. Patients often find that providers aren’t taking new patients, forcing them to go out of network for care, the administration charged. So the Health and Human Services, Treasury and Labor departments proposed rules that would mandate that insurers analyze their coverage to ensure equivalent access to mental health care. The companies would have to look at how they respond to requests from doctors to authorize treatments for mental illnesses, as compared to physical ones, as well as their provider networks and how much they reimburse providers out of network. The rule would also establish when health plans can’t require doctors to obtain the insurers’ prior authorization to prescribe a medicine or procedure, or otherwise put up roadblocks for patients seeking mental health, as well as substance use, treatment. Insurers could face fines for failing to offer comparable coverage for mental health. Kennedy’s role: The eight-term Democrat, who retired from Congress at the end of 2010 and whose mental health efforts are informed by his own struggles, has a new job as a partner at consulting firm Healthsperien, where he plans to promote the regulation with a conciliatory message. “I tell the payers, rather than come up and fight the parity rule, they should come to the White House and say, ‘Here's what we want to do to help you with the workforce shortage,’" he told Ruth. "They have a moral responsibility to help meet this crisis." Why it matters: As of October 2023, more than half of 18- to 30-year-olds were experiencing symptoms of anxiety or depression, according to the Centers for Disease Control and Prevention. And the CDC reports that more than 100,000 people are dying from drug overdoses every year.   JOIN 1/31 FOR A TALK ON THE RACE TO SOLVE ALZHEIMER’S: Breakthrough drugs and treatments are giving new hope for slowing neurodegenerative diseases like Alzheimer’s disease and ALS. But if that progress slows, the societal and economic cost to the U.S. could be high. Join POLITICO, alongside lawmakers, official and experts, on Jan. 31 to discuss a path forward for better collaboration among health systems, industry and government. REGISTER HERE.     WELCOME TO FUTURE PULSE St. John, U.S. Virgin Islands | Shawn Zeller/POLITICO This is where we explore the ideas and innovators shaping health care. Republicans are less enthused than Democrats about AI’s prospects to improve lives. A poll of 1,000 voters from the AI Policy Institute, a research group, found 42 percent of Republicans said AI would be good for them, compared to 65 percent of Democrats. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp.  FOLLOW THE MONEY Britain's health service has seen productivity decline. | Getty Images Worrying signs about the productivity of the health care sector are emerging across the pond. How’s that? A report from a British think tank, the Institute for Fiscal Studies, concludes that the productivity of the U.K.’s National Health Service has tumbled since the pandemic’s outbreak, POLITICO’s Carlo Martuscelli reports. Doctors in Britain are treating about the same number of patients as before Covid hit, but they’re spending much more to do it. Max Werner, an institute research economist and one of the authors of the report, cautioned that the exact reasons for the productivity drop remain an “open question," but there are strong contenders: — Pandemic bottlenecks haven’t fully resolved. — The health of the average person is worse, so it takes more resources to care for the same number of people. — Investments in hospitals, beds and medical equipment have lagged behind new money for staffing. Not alone: The United States has long trailed other wealthy nations in care productivity, spending billions more for worse results. The Organisation for Economic Co-operation and Development, an international group that includes the U.S., projects that, on average, health spending across the group’s 38 member countries could increase to 11.8 percent of gross domestic product by 2040, up from 9.7 percent currently, and 8.8 percent pre-Covid. In the U.S., the figure was 17.3 percent in 2022, according to the most recent data from the Department of Health and Human Services. HHS expects that to grow to 19.6 percent by 2031. Takeaway: “I think all OECD countries … share a number of common challenges,” Stefano Scarpetta, director of employment, labor and social affairs at the OECD, said. “We have seen over the past two or three years now a significant deceleration in economic growth and a lot of uncertainty about the short-term economic outlook.” Scarpetta said that carefully considered investments could help boost productivity, including in artificial intelligence.   Enter the “room where it happens”, where global power players shape policy and politics, with Power Play. POLITICO’s brand-new podcast will host conversations with the leaders and power players shaping the biggest ideas and driving the global conversations, moderated by award-winning journalist Anne McElvoy. Sign up today to be notified of new episodes – click here.     TECH MAZE Roberts | Courtesy of Brooklyn Roberts Where will conservatives come down on artificial intelligence regulation? On Capitol Hill, Republicans are taking a wait-and-see posture as they await President Joe Biden’s first moves. Those could come this year, following a directive Biden issued to agencies in October to come up with guardrails. In the meantime, look to the nonprofit American Legislative Exchange Council for clues. The influential group helps write model bills for GOP state lawmakers, and it’s starting to consider AI. Brooklyn Roberts, senior director of the council’s health and human services task force, spoke with Ruth about how government should balance protecting patients with promoting innovation. The transcript was edited for length and clarity. What is your top concern about AI? Patient safety has to be the primary consideration. What kinds of policies are you looking at? I think health privacy law is very, very dated. It's long overdue for an update. A lot of the proposals that we’ve seen have been around data privacy, and that's obviously going to be very important in terms of security because you have all this health care data that you don’t want hacked, or to get out. So we need a lot of security measures. Connecticut has passed a data privacy law that’s a good example. Is making way for innovation at odds with regulating data privacy? You can protect consumers’ privacy and still have plenty of room for innovation. A lot of times, we consent to share our data, and as long as that consent is fully informed and not coerced in any way, there are a lot of people who voluntarily share data.   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

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