Mental Health Access Improvement Act

Legislation Comparison Grid

Health-related Bill NameMental Health Access Improvement Act of 2019
Bill NumberH.R.945
DescriptionThis bill is aimed at regulating the work of marriage and family therapists, focusing on their activity under the Medicare program. Also, this document involves the issuance of therapists the authority to develop discharge plans for post-hospital services independently (“H.R. 945,” 2019).
Federal or State?State
Legislative IntentThe legislative intent of this document is to introduce a definition of the term “marriage” and “family therapist services” into the law. In the framework of this term, the features of these services are described in detail; requirements for specialists in this field are determined. The name “mental health counselor services” is defined, indicating requirements for them. The question of the remuneration of these specialists in the framework of Medicare Part B is determined. Finally, therapists and psychologists providing mental health services are excluded from the skilled nursing facility prospective payment system (“H.R. 945,” 2019).
Proponents/ OpponentsProponents: Representative Thompson (D-CA) and Representative Katko (R-NY), who put forward the bill, as well as marriage and family doctors and counselors themselves.
Opponents: To date, no apparent opponents of this bill have been found. However, since this project is associated with the Medicare program, corporations that pay taxes on their profits to the program fund may be its potential opponents.
Target PopulationMarriage and family therapists and counselors who, after the adoption of this document, will be able to bill Medicare directly for their services, thereby obtaining the necessary funding (Petruzzelli, 2019).
Status of the Bill (Is it in hearings or committees? Is it receiving press coverage?)The bill is currently in committees, namely the Committee on Energy and Commerce, and in the Committee on Ways and Means.
H.R. 945 is receiving small press coverage; however, there are still articles, blogs, and various websites covering and discussing it. Because of that, there is no problem with finding information regarding this bill.
General Notes/CommentsA similar bill, S. 286., was introduced in the Senate by Senators John Barrasso (R-WY) and Debbie Stabenow (D-MI). Both bills were presented at the very beginning of the 116th Congress with the active support of the AMHCA (“Mental health access improvement act,” 2020 )

Advocacy Statement

The problem of addressing mental health is no less acute and essential than the treatment of physical issues and ailments. However, due to prevailing stereotypes, it is often believed that psychological problems are of less importance and do not require special treatment and approach. Fortunately, recently this situation has changed due to the introduction of various kinds of bills. H.R. 945 is one such project designed to improve the mental health situation of the older generation of American citizens. This bill is of great importance and value to American society, and therefore should be carefully considered and studied.

First of all, H.R. 945 aims to change the working conditions of marriage and family therapists and counselors. In the text of the document, precise definitions are described that explain the essence of the work of these specialists. Among other things, it is indicated who can engage in this type of activity, what requirements for this must be met (“H.R. 945,” 2019). Even this amendment alone makes it possible to structure specialists involved in the provision of mental assistance and to limit the provision of such services to people who do not have specialized knowledge for this. Undoubtedly, a clear consolidation of the concepts of marriage and family therapists and counselors will improve the quality of their services.

There are many problems associated with providing adequate medical care. According to Raviola, Naslund, Smith, and Patel, a combination of factors such as politics, the number of specialists, and financing make the task of timely and high-quality assistance challenging (2019). However, regulating the economic relations between the state and specialists is much more critical. H.R. 945 is precisely the solution to these problems because it finally allows marriage and family therapists and counselors to use the resources of the Medicare program.

This program is aimed at providing health insurance for U.S. citizens from 65 years of age and older. Still, the methodology of its work at the moment significantly complicates the reception of assistance for this group of people. Medicare does not make direct payments to the above specialists, requiring monitoring by a doctor (Petruzzelli, 2019). This dramatically complicates people’s access to the services of this program, since a vast number of people live without direct access to both doctors and medical resources. According to Petruzzelli, almost 77 percent of U.S. regions lack qualified specialists, which is equal to approximately 80 million Americans who cannot be provided with sufficient support (2019). Despite the existence of a program like Medicare, its implementation in practice is very difficult. This bill is aimed to facilitate the implementation of this concept.

Undoubtedly, H.R. 945 does not solve all the existing problems in this area and cannot single-handedly change the whole situation with the provision of psychological assistance. However, this bill allows realizing the opportunities that have already been laid down by the state in the framework of the existing program. The implementation of this project will not lead to a significant increase in tax costs and other deductions in favor of Medicare. Since the money to help the American elderly is already a part of the foundation of this program, H.R. 945 facilitates access to this fund and allows its implementation.

As a concrete example, the relationship between Medicare and marriage and family therapists and counselors will help to manage the opioid crisis in the United States. Since Medicare pays a third of all opioid-related hospitalizations, it can be said that this program is directly related to the fight against this phenomenon (Petruzzelli, 2019). In this case, various public opioid control services will be able to access the services of therapists and counselors through this program, thereby reducing the cost of hospitalization.

Thus, H.R. 945 does make it possible to address many social problems, but this bill still does not cover all the shortcomings of the current healthcare system. Although its goal is to facilitate the access of people throughout the country to the services of therapists, specialists must still be located in the relevant regions to be able to provide these services. Since the current version of the bill does not regulate it in any way, perhaps some amendments should be made to it, which will encourage professionals to travel to sparsely populated regions. In the text of H.R. 945, there is a clause explicitly regulating payments through Medicare for therapists and counselors as 80 or 75 percent of the cost of their services (“H.R. 945,” 2019). As an incentive amendment, a subparagraph can be made that will guarantee increased payments to counselors if they provide their services to patients in remote places. This amendment will help to combat further the acute shortage of specialists throughout the United States.


H.R. 945 — 116th Congress: Mental health access improvement act of 2019. (2019). Web.

Mental health access improvement act. (2020). Web.

Petruzzelli, M. (2019). New legislation enhances Medicare mental health workforce. Web.

Raviola, G., Naslund, J. A., Smith, S. L., & Patel, V. (2019). Innovative models in mental health delivery systems: Task sharing care with non-specialist providers to close the mental health treatment gap. Current psychiatry reports, 21(44), 1-13. Web.

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