On Feb. 1, 2022, the Senate Committee on Health, Education, Labor and Pensions (HELP) Committee convened a hearing to discuss priorities and proposals for bipartisan legislation addressing mental health and substance use disorders (SUD). The discussion signaled that the legislation could be comparable to the SUPPORT for Patients and Communities Act (P.L. 115-271) in terms of its scope, with individual titles of the bill dedicated to different topics (e.g., public health, reimbursement), though the size of the spending package is unclear. The 2018 SUPPORT Act authorized more than $3.3 billion in spending over 10 years.
Bipartisanship. Throughout the hearing, Democrats and Republicans expressed strong interest in working together to pass bipartisan legislation. Many of them referenced bipartisan bills focused on various strategies to reduce the impact of mental health and SUD on communities. Chair Patty Murray (D-WA) noted the Senate HELP Committee’s successful track record on crafting and advancing bipartisan legislation on these issues in 2016 and 2018 – e.g., Comprehensive Addiction and Recovery Act of 2016 (P.L. 114-198), 21st Century Cures Act (P.L. 114-255); and SUPPORT Act.
Legislative Priorities. Lawmakers and witnesses recommended solutions in the following areas, which generally align with priorities outlined by the Senate Finance Committee:
- Strengthening the workforce;
- Expanding, reauthorizing, and improving federal programs, particularly at the Substance Abuse and Mental Health Services Administration (SAMHSA);
- Improving access to mental health care for children and young people;
- Ensuring parity between mental and physical health care;
- Increasing access to care through delivery reforms (e.g., integrating behavioral health with primary care, expanding telehealth, improving prior authorization processes); and
- Preventing addiction to opioid medications through safe prescribing practices and improving awareness of risks.
Overarching Themes. Lawmakers and witnesses also coalesced around key overarching themes to guide policy development:
- Advance health equity and prioritize federal resources for communities that are underserved by the mental health and behavioral health system, including children and youth, people from racial and ethnic minority groups, people living with disabilities, LGBTQI community, and people living in rural areas;
- Support evidence-based and community-based solutions;
- Pursue federal policy actions that tackle the entire continuum of mental and behavioral health care, with increased focus on upstream factors such as social determinants of health; and
- Acknowledge and address stigma.
Next Steps. Though Chair Murray emphasized the need for urgent federal action on mental health and SUD, she did not provide any details on scheduling, such as target timing for a committee markup and Senate floor vote. Given the progress that Chair Murray and Ranking Member Richard Burr (R-NC) have made on their pandemic preparedness legislation, we anticipate that the Senate HELP Committee will first vote on the PREVENT Pandemics Act before considering bipartisan legislation addressing mental health and SUD. In the press release of the PREVENT Pandemics Act discussion draft on January 25, they announced their plans to mark up the legislation “in the coming weeks”; the deadline for submitting feedback is February 4. Still, the introduction of multiple bills addressing mental health and SUD by several committee members provides a solid starting point that will help quicken crafting of the legislation. We expect the Senate HELP Committee bill will be packaged with the Senate Finance Committee (SFC) bill that has yet to be released. SFC will hold a hearing on youth mental health on February 8.
