July 22, 2015
By Fawn Johnson
House Energy and Commerce Committee Chairman Fred Upton and ranking member Frank Pallone independently dreamed up what they think will be their last major health care project before Upton's term as chairman expires at the end of next year: mental-health legislation.
They hope to pass a bill that will make it easier for people with substance-abuse issues, depression, or other mental-health conditions to access treatment, and they're not the only members of the committee who have made that a priority.
The topic has been a near obsession for Rep. Tim Murphy, a senior committee Republican who is also a clinical psychologist. Murphy has led a committee investigation into the federal programs that address mental illness. He has also sponsored legislation to break down barriers between physicians and mental-health professionals, and improve the quality of care. He wants community health centers and hospitals to move away from what he calls "crisis psychiatry," where patients who have severe mental illnesses go untreated until they wind up in the emergency room.
Murphy's ideas have gotten a few bounces in public interest over the last few years, most prominently in the wake of the 2012 mass shooting at Sandy Hook elementary school. But progress has been slow because the constituency for mental health care is relatively small, and it's a hard issue for politicians to embrace. Even so, Murphy's bill won a key endorsement earlier this month from the National Alliance on Mental Illness's Harlem chapter, and the health subcommittee packed a hearing room when it took testimony on the bill in June.
Enter Upton and Pallone to add spark to the debate. Overall, committee operations are going well. Three major pieces of committee legislation—on medical innovations, chemical controls, and Internet domain names—have passed the House with major bipartisan margins. Both committee leaders say it's time to harness what is becoming a committee habit in service of mental health. As with the other measures, they'll start by combining Republican and Democratic priorities and seeing what happens. There's probably a bipartisan agreement in there somewhere.
It helps that Upton and Pallone are restless to do more. Less than a week after the House passed the committee's 21st Century Cures bill, Upton was already scheming about his new mental-health project. As it turns out, so was Pallone. When Upton sat down with National Journal for an interview, he had already hunted Pallone down on the House floor to discuss it and was readying himself for a meeting with Murphy later on.
As Upton described his Pallone encounter, it was a classic meeting of the minds. "Frank was coming up the aisle. I say, 'Frank, I've been looking for you.' 'Oh, I've been looking for you. Let's sit down. You go first.' 'No, you go first.' "
Upton finally got to the point. "I said, 'I want to talk to you a little bit about mental health and what I want to do with it, and work with you.' … He said, 'That's exactly what I was coming over here to talk to you about. We want your involvement to try to put something together.' "
There you have it. All it took was friendly conversation between the top Democrat and Republican on the committee to commit to writing a mental-health bill. Now it's on both lawmakers' priority lists. "The feeling is we're not addressing the problem," Pallone said. "A lot of people are not being able to access mental-health services. That's the concern."
The committee's mental-health efforts, if successful, will supplement a long list of smaller public-health bills the panel has completed over the last year. Members have addressed all sorts of niche health issues like hearing loss and drug addiction in babies. They are putting finishing touches on legislation to aid the first responders from the 9/11 terrorist attacks.
What they aren't doing is spending a lot of time talking about Obamacare. The Supreme Court's recent decision in King v. Burwell took the wind out of Republicans' sails when it comes to the Affordable Care Act. It's true that there is a concerted effort from some GOP lawmakers to pass an ACA repeal using a partisan budget maneuver. But that's mostly for show. Everyone knows the president will take about two seconds to veto it and nothing will change.
"I don't think you're going to see us do any more on the repeal effort necessarily," said Rep. Greg Walden, a senior Republican committee member. "The next piece, really, is, how are Americans being affected by a federal health care law like this? Are their premiums going up or down? … What about overhead costs? What about access?"
Pallone couldn't agree more that the next steps regarding Obamacare should involve assessments about how it's working rather than efforts to repeal it. "I'm reluctant to make changes in the ACA only because I think that it has to play out for a few years. But you know, we're going to have to constantly have oversight," he said.
Pallone sees the Supreme Court decision as a blessing for the committee, because it allows Democrats and Republicans to continue their friendly partnership that has developed this year. "I'll be honest with you. My fear was we were going to spend the first six months doing all these good things and then the court would rule against us, and then we spent the next 18 months of the session having to deal with replacement or major changes to make sure people had health insurance," Pallone said. "Now that that's over with, I think there really is an opportunity to work on a bipartisan basis on a bunch of issues."