Earlier today, U.S. Senator Catherine Cortez Masto (D) and a group of Democratic Senators hosted a press call to discuss mental health care in the age of COVID-19. This came hot on the heels of House Democratic leaders releasing the HEROES Act, their long-promised “CARES 2.0” legislation that addresses a wide array of issues, including health care.
So what’s in the HEROES Act? And what do we still need to do to solve our health care problems that have been exacerbated by this public health crisis?
So, about that HEROES Act…
Yesterday, House Speaker Nancy Pelosi (D-California) officially unveiled the HEROES Act, or the “CARES 2.0” package that Congressional Democratic leaders have been promising for just over a month. The $3 trillion relief package includes just over $900 billion for state, local, and Native American tribal governments, almost as much as what Governor Steve Sisolak (D) and several other Western state elected leaders requested earlier this week.
In addition, the HEROES Act includes another round of $1,200+ “corona checks” ($1,200 baseline for each adult earning $75,000 or less annually, plus $500 per child), expansion of the Paycheck Protection Program (PPP) for small business aid, and a new hazard pay program that amounts to a $13 hourly boost in wages for essential workers in the health care, food retail, public safety, and transportation sectors.
On top of all that, the HEROES Act includes Rep. Steven Horsford’s (D-North Las Vegas) proposal to fully subsidize nine months of COBRA health insurance for qualified furloughed and laid-off workers. Also on the health care front, Democrats’ new bill offers a nationwide Affordable Care Act (ACA, or Obamacare) insurance exchange special enrollment period similar to what Sisolak has provided Nevada Health Link from March 17 through this Thursday. The bill also includes an expansion of the FMAP that will further boost federal Medicaid reimbursement for states.
During a press call with U.S. Senator Catherine Cortez Masto and several of her Senate Democratic colleagues, we were reminded of another critical health care issue: One that doesn’t always get the attention it demands, and one that shines a harsh light on our larger health care challenges that existed before the COVID-19 pandemic and have only been exacerbated in recent weeks.
“We are one of the eight states with certified behavioral mental clinics. I want to see more. No one should be turned away.”
– U.S. Senator Catherine Cortez Masto
We’ve talked before about America’s (particularly Nevada’s) struggles with mental health care, including my own challenges on this front. The HEROES Act includes $3 billion in additional mental health care funding. But during today’s call, the Senators acknowledged that Congress must do more.
As Senator Debbie Stabenow (D-Michigan) put it, “When we say health care, we mean health care above the neck and health care below the neck.” She continued, “For decades, behavioral health care was overburdened and underfunded. Before the ACA, it wasn’t considered an essential health benefit.” Later in the call, Cortez Masto acknowledged how severe this disparity has been here in Nevada: “Coming from Nevada, I know what happened during the 1990s. We cut mental and behavioral health services, and we still haven’t caught up yet.”
Cortez Masto then praised the state’s three certified community behavioral health clinics (one in Las Vegas, one in Fallon, and one in Elko) that opened thanks to a special federal two year grant. The federal grant expired last year, so the state has since provided 75% of the funding needed to keep the three community behavioral health clinics open. But now that Nevada’s state budget has officially entered fiscal emergency status, Cortez Masto hinted that she wants the federal government to step up to avoid a return to the bad old days of “patient dumping”.
As Cortez Masto admitted, “Coming from a state like mine, Nevada, I know that behavioral health is often among the first budgets to get cut when tough times arrive. It does a disservice to so many who need behavioral health services.” She later added, “We are one of the eight states with certified behavioral mental clinics. I want to see more. No one should be turned away.”
“It is true that you are better off having health insurance than lacking it.”
– U.S. Senator Chris Murphy
It’s not hard to figure out why there’s a huge need for mental health care during these times of pandemic. With people fearing for their own physical health, people losing loved ones to COVID-19, and people losing jobs and livelihood as the result of the economic fallout, this crisis is hitting people hard above and below the neck. And yet, we’re only now beginning to acknowledge the lack of sufficient and secure telehealth services and the systemic underfunding of mental health care (at the federal and state levels) in addition to the continuing challenge of unaffordable and unavailable health insurance.
As Senator Chris Murphy (D-Connecticut) pointed out, “It is true that you are better off having health insurance than lacking it.” He then expressed outrage over the Trump administration’s redoubled efforts to push federal courts to do what Congress has refused to do in repealing the ACA: “It is heartbreaking to me that this president is trying to destroy this law, that he is sending his lawyers out to argue against this law in court, at the exact time when people need health insurance the most.”
So far, President Donald Trump has not even bothered to specify the “replace” part of his latest “repeal and replace Obamacare plan”. Yet when it comes to House Democrats’ HEROES Act, some progressives have derided COBRA expansion as a “health insurance industry bailout” because it subsidizes very high insurance costs for a select number of Americans while leaving out those who don’t qualify for COBRA depending on whether or not they got health insurance from their last employer.
This right here illustrates the dilemma. For the constant use of mental health as a political football, especially when it comes to far-right politicians’ excuses for opposing gun safety legislation, mental health care funding and infrastructure continue to lag behind Americans’ need for care. And even though the matter of mental health care ties into the larger problem of Americans being denied the health care they need, it remains to be seen when policymakers will prescribe all the strong medicine we need for all our problems, big and small.