Illinois bill could make mental health care more affordable
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The Illinois General Assembly is considering a bill to increase reimbursement rates for mental health care providers, which supporters say would mean more affordable patient care.
The big picture: Private insurance companies reimburse physical health care providers 22% more on average than mental and behavioral health care providers, leading many of those providers not to accept insurance, according to RTI International. This forces patients to pay out of pocket or find a new provider.
By the numbers: About one-third of practicing psychologists don't take insurance, according to the American Psychological Association.
- On the patient side, users went out-of-network 3.5 times more often for mental health and substance use needs than physical health needs, according to RTI.
How it works: The bill would direct commercial insurance companies to reimburse providers amounts equal to or greater than 141% of the Medicare rate for mental health or substance use disorder care.
Zoom in: "We have not received raises that honor inflation in 26 years," a Chicago therapist in private practice tells Axios.
- Axios agreed to grant anonymity to the therapist because their contract with the insurance companies forbids discussing rates.
- "Blue Cross Blue Shield (BCBSIL) reimbursement rates have increased $12.50 since 1999 and some years, our rates decrease," the therapist says.
- For example, if the therapist charges $185 a session, the reimbursement could be about $130 or less but depends on the rates set by insurance companies, they tell Axios.
What they're saying: "I have to see six to seven people a day to make my bills. We are all burning out and I can't tell my clients I'm going out of network. No one could afford me, and my rates aren't even competitive. I'd lose everybody."
The other side: "BCBSIL is committed to expanding access to quality, cost-effective physical and behavioral health care across Illinois. We don't comment on proposed legislation," spokesperson Dave Van de Walle tells Axios.
- "We have increased reimbursement for professional, inpatient, and outpatient behavioral health care providers consistent with multiple factors, including, among other things, Medicare reimbursement increases."
Zoom out: State Rep. Lindsey LaPointe (D from the Northwest Side), the bill's sponsor, tells Axios that she's heard from colleagues on both sides of the aisle about the necessity of accessible and affordable mental health care and she's optimistic about it passing.
What's next: Lawmakers are scheduled to discuss the bill Thursday at the House Mental Health and Addiction Committee.