APA Statement on the House Passage of the Build Back Better Act

Nov 19, 2021

WASHINGTON, D.C., Nov. 19, 2021 – The U.S. House of Representatives today passed the Build Back Better Act, which, among its $2 trillion in spending, includes significant needed investments in mental health and substance use disorder care. The American Psychiatric Association (APA) applauds the House for including these provisions in the Act and urges the Senate to ensure they are retained in the final reconciliation package.

Among the many health care provisions APA supports are those expanding:

• Mental Health Parity: The 2008 federal parity law requires that insurance coverage for mental health and substance use disorder (MH/SUD) services be no more restrictive than coverage for other medical care. Full compliance with this law has yet to be achieved but is essential given the heightened need for these services during the pandemic. As a follow-up to last year’s strengthening of the federal parity law, the Act includes provisions levying civil monetary penalties on those found to be in violation of parity law requirements.

• Behavioral Health Workforce: The increased need for MH/SUD services during the pandemic has highlighted the significant behavioral health workforce shortage, especially for patients of color and others who have been historically underserved and marginalized.
• This Act would fund 4,000 new, Medicare-supported graduate medical education slots in 2025 and 2026, the largest increase in more than 25 years, and would allocate 15% of the new residency slots to psychiatry and other behavioral health training programs.
• It provides $75 million in funding to award grants to establish or expand programs to grow and diversify the maternal MH/SUD treatment workforce.
• The Act includes an additional $50 million for the SAMHSA Minority Fellowship Program.

• Crisis Services: Evidence-based crisis services have proven effective in reducing costly emergency department boarding, freeing law enforcement officers from managing MH/SUD patients in crisis, and diverting patients with severe mental disorders away from the criminal justice system and into appropriate treatment and care. The Act makes permanent an increase in Medicaid funding for mobile crisis response and includes $75 million in funding for the National Suicide Prevention Lifeline to help expand programs as the Lifeline transitions to the new 9-8-8 number next summer.

• Access to Care: Timely and regular access to mental health care is essential for patients. The Act provides 12 months of continuous eligibility to children enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) and permanently extends the state option. It also makes investments in Medicaid by extending coverage to 12 months postpartum, permanently enhancing federal funding for the territories, and covering people 30 days prior to leaving jail or prison. In addition, the Act boosts access to care through Certified Community Behavioral Health Care Clinics and expands tax credits for purchasing insurance through the Affordable Care Act marketplaces.

American Psychiatric Association

The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 37,400 physician members specializing in the diagnosis, treatment, prevention and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information please visit www.psychiatry.org.