By Peter Sullivan
November 4, 2015
A House panel on Wednesday advanced a sweeping mental health reform bill after a fiery debate where Democrats objected that they had been cut out of the process.
The bill, sponsored by Rep. Tim Murphy (R-Pa.), which overhauls the system for treating seriously mentally ill people, was billed as the Republican response to the 2012 Sandy Hook Elementary school shooting when the measure was first introduced in 2013.
It has been controversial and delayed for years, but is now starting to move forward. The House Energy and Commerce health subcommittee advanced it on a mostly party line vote of 18-12 on Wednesday.
“This bill will save lives,” Murphy said at the committee meeting. “This bill will prevent people with serious mental illness from being involved in acts such as Sandy Hook.”
While the bill has 45 Democratic cosponsors, mostly off the committee, Democrats on the panel strongly objected to the way Murphy had handled the bill, saying that he had not been willing to negotiate with Democrats.
Rep. Frank Pallone (D-N.J.), the committee’s top Democrat, argued Murphy had often been more interested in media appearances than negotiating.
“There’s never been an effort to actually address our concerns,” Pallone said. “Oftentimes instead we’ve seen Mr. Murphy go out on the road, talk to the newspapers, do all kinds of media events, but never actually address our concerns.”
“I blame Mr. Murphy for that,” Pallone added about how the process had been handled. “I’m sorry, I have to say that.”
Murphy responded that there had been 37 lawmaker meetings and 14 staff meetings on the bill. “Quite frankly, nothing was offered in terms of other wording on the other side of the aisle,” he said. He did pledge to work with Democrats moving forward.
Democrats agreed that there had been meetings, but said they were only general discussions, and there had never been negotiations on specific changes.
One of the most controversial parts of the bill gives a two percent increase in federal grants to states with what are known as Assisted Outpatient Treatment (AOT) laws, where judges can mandate treatment for patients with serious mental illness.
Democrats have raised concerns with bringing the court system into care for the mentally ill.
Another controversial area of Murphy’s bill is its changes to a health privacy law known as the Health Insurance Portability and Accountability Act, or HIPAA. The changes are aimed at allowing caregivers and family members to have more information about a mentally ill person’s care.
Democrats warn that the changes would lower privacy protections for mentally ill people.
The committee’s Democrats offered a substitute amendment, which was defeated, that aimed more at providing funding for prevention efforts. Democrats have criticized Murphy’s bill for focusing on crises involving seriously mentally ill people at the expense of funding for prevention, substance abuse, and other issues.
Murphy argues his bill “shifts the direction away from the softness of behavior wellness to really working on mental health.”
Other key provisions of the bill free up Medicaid to pay for more mental health services. The bill would undo restrictions preventing Medicaid from paying for physical and mental healthcare on the same day and from paying for care at certain mental health facilities.
However, there is an issue with cost and finding ways to pay for the bill. The Congressional Budget Office on Tuesday estimated the Medicaid provisions could cost a daunting $40 to $60 billion over ten years. CBO analyzed an earlier version of the bill, and some changes have been made since then.
Still, Energy and Commerce Chairman Fred Upton (R-Mich.) on Wednesday noted the CBO report and said he would have to speak to new Speaker Paul Ryan (R-Wis.) about the new Medicaid spending.
Backers hope there is some momentum for mental health reform, as there is also a similar bill in the Senate sponsored by the bipartisan pair of Sens. Chris Murphy (D-Conn.) and Bill Cassidy (R-La.).
Upton said he hoped House Democrats’ concerns can be addressed in a bipartisan way before the full committee considers the bill, at a time that has not yet been set.
“We want the process to move forward,” Upton said. “It’s been years.”