House approves bill focused on mental health insurance benefits

_{Editor's note: This story was updated on April 5 to reflect that the House gave the measure final approval.}

Texas House members endorsed a bill Tuesday that would prevent health insurance companies from offering mental health benefits differently from medical benefits and offer more help for consumers who believe their insurance is wrongly denying them coverage.

Rep. Four Price, R-Amarillo, chairman of the House Public Health Committee, and author of House Bill 10, said on the floor that his bill gives the Texas Department of Insurance more power to enforce how health insurance plans offer mental health and substance abuse benefits. He said that insurance companies are offering mental health and substance abuse benefits but that Texans currently have nowhere to turn to in the state when problems arise. 

“Folks are paying for coverage, they’re just not able to access adequate treatment,” Price said. The bill, which the House tentatively approved in a 130-12 vote Tuesday, is now eligible for final passage in the House. (Update, April 5: The Texas House gave final approval to HB 10 on Wednesday.)

Under HB 10, insurance companies offering mental health and substance abuse care benefits would not be allowed to make such coverage different than how medical benefits are covered. Price told members that the bill was not meant to expand insurance coverage for mental health services. In the past, patients who wanted more care or counseling services either had to seek individual approval or pay out of pocket.

The bill comes as both chambers aim to overhaul how Texas gives access to services and cares for mental health patients. The 2010 Affordable Care Act classified mental health and addiction services among the essential health benefits that must be covered by small and individual plans, without annual or lifetime caps on benefits. The law built upon 2008 federal legislation that called for large group plans to offer mental health benefits on par with other medical coverage.

Days before the legislative session started in January, the Select Committee on Mental Health released its findings from eight hearings in a report saying that if Texas lawmakers didn’t take bolder steps to fix the state’s mental health system, they do so “at our own peril.”

Some of the recommendations included giving the Texas Department of Insurance more power to investigate behavioral health plans and enacting a state mental health parity law. The agency received a dozen complaints of alleged mental health parity violations in the past year, and only one was confirmed.

HB 10 would also require the Department of Insurance to create an ombudsman for behavioral health to help uninsured and insured consumers access mental health services. The ombudsman would also be responsible for tracking and reporting on how insurance companies are stacking up with providing mental health benefits.

Another provision of the legislation would be for the Texas Health and Human Services Commission to create a Mental Health Condition and Substance Use Disorder Parity workgroup under its Office of Mental Health Coordination. The workgroup would be required to recommend how Texas can improve compliance with state and federal statutes on mental health benefits and make it easier for patients to file complaints.

HB 10 is one of four major mental health bills Price is pushing this session. Price is also the author of House Bill 11, which would bolster requirements for how schools address student mental health; House Bill 12, which would change how law enforcement deals with people with mental health and intellectual disabilities and tries to divert them away from jails; and House Bill 13, which would require the Health and Human Services Commission to create a matching grant program for private and nonprofit groups providing mental health services in communities. HB 13 has been voted out of the House Public Health Committee.

Sen. Judith Zaffirini, D-Laredo, is the author of Senate Bill 860, which is identical to HB 10 and is being considered in the Senate Business and Commerce Committee on Tuesday.

Read more of the Tribune’s related coverage:

• In a report released Thursday, Texas House Select Committee on Mental Health members wrote that mental health “is absolutely one of the most critical areas of concern” facing the state.
• As Republicans prepare to dismantle Obamacare, mental health advocates are worried that benefits for counseling and substance abuse treatment will be lost in the shuffle.
• Texas lawmakers tout recent improvements to the state’s mental health safety net, citing new funding and program expansions. But the state still struggles to provide psychiatric care for all patients who need it.