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Medicaid proposal would allow private health plans to cover mental illness | New

LANSING – Michigan lawmakers plan to integrate mental and physical health care to make it more affordable, accessible and reliable for the state’s poorest citizens.

The proposal builds on Medicaid programs and has been the subject of two recent state Senate hearings. Medicaid treatment today separates physical and mental health, making it difficult for patients to get appropriate treatment because they cannot receive care from a single professional.

Advocates want to reduce the stigma of receiving mental health treatment and increase follow-up treatment.

But critics fear that allowing private health insurers to provide services will funnel part of Michigan’s $ 3 billion Medicaid mental health budget into the pockets of for-profit companies.

Yet supporters of the legislation say they are encouraged.

“I have never seen more interest than now in addressing the behavioral health needs of our population in a bipartisan way,” said Dominick Pallone, executive director of the Michigan Association of Health Plans. “I think the pandemic has catalyzed policy makers around recognizing the need for major reforms and major improvements for behavioral health services.”

Similar measures have been adopted by 33 other states. The idea is to revamp the mental health code to maximize services for the Medicaid-eligible population, as most people with private insurance already receive this integrated care, said Senator Mike Shirkey, R- Clarklake, co-sponsor of Bill. It is a systematic problem.

“A substantial amount of costs and problems associated with physical health (for those who benefit from Medicaid) are directly related to this mismanagement of mental health,” said Shirkey.

The integration of care would bring all services together under one roof, making the system much easier to navigate.

“People wouldn’t have to be ping-pong between systems,” Jim Haveman, the former director of the Michigan Department of Community Health who helped write the code in 1995, said in a telephone interview.

But Tom Watkins, former director of the state’s mental health department, said it was a mistake to call the bill integrated care.

“What it is is transferring $ 3 billion of public money to private, often for-profit companies,” Watkins said in a telephone interview. “We should be focusing on serving people, not making a profit for the company. “

The reality is that public health care is already sponsored by private companies, Shirkey said.

“I categorically reject the straw man’s argument about private business,” Shirkey said. “It’s already important in the way we deliver health care, even in the public sector. “

Privatization is not the only concern. Community mental health agencies oppose the proposed legislation and instead recommend focusing on funding certified community behavioral health clinics.

Funding for such services would open the same services to all voters, regardless of Medicaid or insurance status, said Julia Rupp, CEO of HealthWest, the Muskegon County community mental health program.

“The answer is not financial integration,” Rupp said at a recent Senate committee hearing. “I believed that it was.”

HealthWest was one of three pilot projects around Michigan participating in the Section 298 program, which was a trial for integrated mental and physical health care in 2018. However, it was a publicly funded financial integration, where Shirkey’s bills allow private companies.

People agree the system needs to be fixed to better serve Michigan residents, and the focus needs to be on healing the whole person – true integration, said Lisa Williams, CEO of West Michigan Community Mental Health.

Yet nothing in the bills limits community mental health services, Pallone said. All they do is bring in private companies, which have to contract with community mental health, to compete. Not in terms of money, but in terms of care.

“We don’t want to do anything to rule out community mental health, but we want to give people the option to choose if they don’t like their provider,” Pallone said.

The goal of these bills is integration, but advocates are really looking to better serve mental health patients on Medicaid.

“We don’t see mental health as an illness, we see it as an exclusion from health care,” Haveman said. “Mental health is an illness and we have to treat it as such. “

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