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Policy Exploration #2: H.R.5201/Telemental Health Expansion Act of 2020 (TMHEA)

Summary of the H.R.5201 Telemental Health Expansion Act of 2020


The Telemental Health Expansion Act of 2020 (TMHEA) aims to amend Title XVIII of the Social Security Act to provide coverage under Medicare to certain mental health services, namely those furnished by virtual means, and especially those in more rural areas. The bill also aims to permanently remove site requirements on such services as imposed by Medicare. (Presently, these services are excluded from the site requirements through the end of the COVID-19 emergency.) It was introduced to the House of Representatives on 20NOV2019, and as of 24DEC2020, the bill is on the House Union Calendar (the general schedule for laws up for review in the House.)


The beneficiaries of the TMHEA are virtual mental health services who would normally be limited by existing site requirements and limited in their ability to acquire Medicare coverage. In turn, the customers of these services who would indirectly benefit from reduced cost and ease of access may also be considered beneficiaries.


The targets of this legislation are the Centers for Medicare and Medicaid Services (CMS) and telemental health services. The CMS are the main authoritative body of Medicare, and would therefore be responsible for ensuring the exclusion of telemental health services from geographic requirements when the COVID-19 emergency is through. As the services are explicitly subject to less regulation as a consequence, they can be said to be targets as well.


The instruments in this policy are the amendment to be made to Title XVIII of the Social Security Act and the new provision for permanent exclusion of telemental health services from geographic restrictions.


The prospective outcomes of the TMHEA revolve around the expected expansion of range for telemental health services in the United States. Secondary outcomes of this would include expansion of access of essential mental health services to communities that would normally be unable to enjoy mental health services without travelling a long distance, as well as reducing costs of the services and further increasing broad access to those unable to afford them by allowing access to Medicare for payment.


This law and a majority of the laws I will cover tend to revolve around what I perceive as laws principle to the function of our service, both in the concrete legal/economic sense and the general moral sense that comes in healthcare. In other words, laws like these represent the classic circle of 'if more people can afford help and have to jump through fewer hoops to get it, we can give help to more people' that our company is founded on. The strength of the TMHEA specifically is that it's a straightforward bill with straightforward appeal, and I don't see any particular drawbacks relative to us. It doesn't represent an intense overarching sociocultural shift or a "threat" or anything like that, especially when you consider the federal government can be very touchy about insurance law. If anything, it really comes off as a product of its time, and it comes as part of a nationwide trend of addressing the glaring disparities in health access (this one at least regarding geographic limitations) that have had extra light shone on them because of COVID. While I can't say it for certain because of the complexities of the legal process, I have a hunch bills that are single consummate provisions, deregulations and/or amendments to earlier law like the TMHEA may have an easier time getting out of committee and potentially becoming law than larger ones with the same intent. While I feel we definitely need more drastic change to occur, smaller steps like this making it out of committee and onto the calendar at least lead me to believe any positive change is possible, and while that's merely a symbolic victory, it's nice to have any reason not to be cynical about the process. Ultimately, I speculate the TMHEA or a similar bill like the ones I will discuss have a good chance of passing with bipartisan support, and this is wholly a good thing from what I can gather.


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