Hours after Gov. Kelly Ayotte called on lawmakers to force private insurers to cover mental health services for children, a House committee voted to shelve the legislation.
The governor’s push came after months of heated debates over Senate Bill 498, which would have closed a coverage gap currently costing taxpayers and the state roughly $2 million a year to fund a behavioral health program for privately insured children ages 5 to 21.
Ayotte singled out Anthem Blue Cross Blue Shield, which insures the largest share of children enrolled in the state’s Families and Systems Together (FAST) Forward program.
“It’s appalling that Anthem and other carriers would deny coverage for critical services to any child experiencing a mental health crisis,” she said in a statement. “I urge the committee to advance this legislation so we can hold insurance companies accountable and protect coverage for mental health services for some of our most vulnerable children.”
FAST Forward is a wraparound program offering individualized care, including peer support, crisis planning and family-centered services.
While private insurers cover some services under the program, they do so piecemeal rather than at a bundled rate.
Katie Lyon-Pingree, a mother from Bow said she was never made aware of this service during her son’s struggle with mental health, despite the many interventions he received.
“The system we have is a joke. It is an insult to families,” Pingree said about her family’s options in New Hampshire. Before his death, they sent their son Matthew to a program in Utah, but could have kept him home with the right support.
Advocates say the success of the program lies in bundling services, as it would allow teams to provide coordinated services, from school counselors and therapists to caregiver respite, individualized plans, and any other support a family might need.
Jim Turner, a spokesperson for Anthem Blue Cross Blue Shield, said the company is disappointed by Ayotte’s comments and that the bill poses many concerns.
He said the legislation would create a nonprofit board that could charge fees on commercially insured small and large businesses and individuals.
“The fees would fund undefined mental health services with two Medicaid-contracted care-management entities, or CMEs,” he wrote in a statement. “Because these CMEs provide services for Medicaid and not commercially insured members, Anthem has been working in good faith with them on a path forward. We are committed to ensuring that all children who need it have access to high-quality, clinically appropriate behavioral healthcare.”
The bill cleared the Senate, but hit a wall Wednesday when the House Commerce and Consumer Affairs Committee voted it down 13-4, sending it to interim study instead.
Morissa Henn, deputy commissioner of New Hampshire’s Department of Health and Human Services, said the vote was a disappointing blow, coming on the heels of the $51 million the legislature slashed from the department’s two-year budget last year.
“We are having to tighten our belts on programs and on positions, and at a time of increasing mental health need for New Hampshire families, this gives us great concern,” she said. “We hope that the significant dialog and the way in which this bill has attracted so many individuals and families to come forward and share their stories will allow us to really get to the finish line, whatever that takes, whether it’s legislative or non-legislative.”
Years without resolution
In legislative hearings, representatives of private insurers, especially from Anthem Blue Cross Blue Shield, said negotiations with mental health care providers had ramped up in recent weeks.
“We have met with the state on multiple occasions to work toward resolution, and just yesterday we joined other health insurers in signing a letter to the Governor ensuring she knows we are eager to work with the state on this matter,” Turner said in a statement.
Private insurance companies and their lobbyists have testified against the legislation.
The governor’s office accused Anthem of stringing along mental health care providers with years of “hollow promises.”
Despite the committee’s decision to shelve the bill, it will still face a full House floor vote.
Henn echoed the governor’s office, saying the state has spent more than five years working alongside insurance carriers and the New Hampshire Insurance Department to find a solution, but despite ongoing collaboration, families are still waiting for one.
“I was heartened that she understands that we as a state and families in need cannot afford another five years of talk,” she said. “Collectively, we are concerned about continued negotiation without real impact, while families continue to struggle to access care.”
