A Colorado bill that would require insurers to cover annual mental health wellness exams is back this year, and sponsors say it has a good chance of becoming law because they have an agreement with the governor.
Colorado would be the first in the nation to do this, at least according to sponsor Democratic Rep. Dafna Michaelson Jenet of Commerce City. To her, HB 21-1068 is an attempt to treat mental health like physical health is treated.
“Colorado was in a mental health crisis (before the pandemic),” Michaelson Jenet said. “This year, we’re in an even greater mental health crisis because of COVID. The sooner we get to putting mental health care on a wellness basis just like we do on a physical, the sooner we’re going to see the benefit of reduced crisis interventions that are required.”
The mandate would first apply in 2022 to the large-group market, which covers about 650,000 Coloradans. Michaelson Jenet said Colorado would only need more mental health professionals if everyone tried to get the exams at once, but ultimately, she hopes the reduction in crisis intervention services means there would be enough providers.
This year’s bill is sponsored by all Democrats, and the Colorado House Health and Insurance Committee voted to pass the bill unanimously Wednesday afternoon. No one testified against the bill, but several people said this type of assessment would have helped them get treatment for their mental and behavioral health issues before they became larger problems.
Gov. Jared Polis opposed the bipartisan bill last year because it lacked a cost analysis. This year’s bill would include that. His office did not return multiple requests for comment about this year’s bill.
But there was another worry about the bill, that the federal government could fine Colorado to “defray costs” that increase premiums in the individual and small group markets. That’s because of the Affordable Care Act, which was instituted in 2012.
Under the law, every state was required to pick a “benchmark plan” that already existed on the individual market in 2013. The benchmark was updated in 2017, and the Trump administration allowed states to update their benchmark plans again, which Colorado is in the process of doing for 2023. But the state isn’t allowed to change copays and deductibles.
“What (the federal government was) worried about was that states would pass a whole slew of mandates after the Affordable Care Act came into place and that would then make the tax credits increase that they had to pay,” Colorado Commissioner of Insurance Michael Conway said.
Conway said Colorado doesn’t anticipate getting fined, but rather that, if the bill passes, the government will ultimately approve Colorado’s request for the new standards — mental health wellness exam coverage included. Michaelson Jenet also said the bill achieves the goals of the federal Mental Health Parity law, which prevents health insurers that cover mental health treatment from imposing more restrictions than they do on physical treatments.
If the bill passes, the individual and small group markets would offer the exams in 2023 (one year after the large group markets) as part of the new benchmarks.
The Colorado Association of Health Plans’ Executive Director Amanda Massey said data from 2019 estimates the mandate would cost insurers $6 million annually (which about 0.1% of fully insured premium costs in Colorado). The cost would increase over time as more people used the benefit, she added.
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