In the 2020 legislative year we saw a remarkable and necessary step to increasing the access to health care, particularly mental health care, in the form of House Bill 1623. This bill required that Medicaid and private insurers cover all telehealth appointments, for both physiological health and mental health, through video and through telephone, and at the same rate for in-person sessions. It gave some power back to practitioners, allowing for quality health care services to be provided in a way, especially during the pandemic, that keeps everyone safe and allows for services to be more accessible to every person.

As a result of the bill, practitioners have been able to see individuals in the North Country, where mental health practitioners are in a worse supply than they are in the rest of the state. They have been able to find psychiatrists and nurse practitioners and have medication appointments with less difficulty. Scheduling became less of a concern as patients were able to find time during a lunch break, allowing for more flexibility in appointments since there was not the drive and parking to get to the office.

In the stroke of a pen, Gov. Chris Sununu made access to mental health easy to anyone with just a phone line.

House Bill 602 threatens to remove the progress and security of an already fragile mental health system. The bill would allow insurance companies to reimburse at a lower rate. This makes it unsustainable for practitioners.

Rep. Jess Edwards, one of the bill’s sponsors, states, “The cost structure of telemedicine and in-person care are widely different.” Having the ability to provide telehealth services does not reduce overhead costs. It does not reduce requirements (nor should it) for practitioners to have a private area to conduct sessions. It does not reduce my need to keep records. It does not reduce my training. It does not make practitioner expertise or skills less valuable. It does not decrease any requirements of any practitioner. It serves to cripple the little guy and let the insurance companies continue to dictate the care of the patients.

Edwards states, “It will inhibit the necessary re-engineering of the health care system.” This argument falls flat for a simple reason: We have managed, in less than a year, to re-engineer health systems. According to the CDC, telemedicine in March 2020 was up 154% over March 2019. Forrester Research has predicted that national telehealth visits could top 1 billion. According to the American Psychological Association, 84.7% of practitioners use telehealth as a means of appointments with practitioners for more than 76% of their visits.

If HB 602 is passed it will do nothing more than reduce the already sparse amount of services in New Hampshire. We will see an increase in wait times for hospital beds, as we will have more people unable to find a therapist. We will have more therapists decide that they cannot see people through telehealth because it is not financially viable. We will continue down the road of inadequate mental health care.

Some practitioners may decide to close their doors because of a lack of financial sustainability, thereby affecting the overall well-being of those struggling with mental health issues. There is lack of care in all of New Hampshire, and it is very heavily felt in rural areas. These changes to the law will be detrimental to the state.

To preserve the progress made, it is important that our voices are heard. Please contact your local representative and let them know that we need access to all health care, now and in the future, and that HB 602 will prevent it.

(Scott Wilson lives in Nottingham.)