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Illustration: Aïda Amer/Axios

America's mental health care system is in dire need of an overhaul, but the any real specifics are largely missing from the 2020 debate about health care.

Why it matters: Suicide and drug overdose rates continue to rise, and the U.S. faces a shortage of mental health providers and a lack of access to treatment.

The big picture: Private insurance is plagued with holes in mental health coverage. Even even though insurers are legally required to cover behavioral health the same way as physical health, they don't.

Yes, but: Medicare to All may not solve the problem, Mental Health America president and CEO Paul Gionfriddo told me.

  • “Medicare would need to be redesigned significantly," he said.
  • Medicare has its own coverage flaws. It would also be crucial to design a system that encourages preventive and early identification services rather than just post-crisis care.

There's also a shortage of mental-health providers. Paying mental health providers more could help address this, but care delivery would also need to be redesigned, Gionfriddo said.

  • Rural areas, for example, would likely still struggle to attract and support these providers because of their remoteness and population size.
  • "The big wild card is how many mental health providers would participate in a Medicare for all program or opt out of insurance entirely," said the Kaiser Family Foundation's Larry Levitt.

For Democrats who support Medicare for All, highlighting how it could help mental health care could have a political upside.

  • “Talking about mental health care needs humanizes the candidates, indicts the shortcomings of private insurance and provides rationale for the need for significant reforms around the current system," Democratic health consultant Chris Jennings said.

The bottom line: "We have a huge problem with health insurance for mental health. A major reform could be an opportunity to improve mental health services, but it could also do harm to them," Gionfriddo said.

Go deeper: Mental health coverage is getting worse

Go deeper

2 hours ago - Health

U.S. surpasses 25 million COVID cases

A mass COVID-19 vaccination site at Dodger Stadium on Jan. 22 in Los Angeles, California. Photo: Mario Tama/Getty Images

The U.S has confirmed more than 25 million coronavirus cases, per Johns Hopkins data updated on Sunday.

The big picture: President Biden has said he expects the country's death toll to exceed 500,000 people by next month, as the rate of deaths due to the virus continues to escalate.

GOP implosion: Trump threats, payback

Spotted last week on a work van in Evansville, Ind. Photo: Sam Owens/The Evansville Courier & Press via Reuters

The GOP is getting torn apart by a spreading revolt against party leaders for failing to stand up for former President Trump and punish his critics.

Why it matters: Republican leaders suffered a nightmarish two months in Washington. Outside the nation’s capital, it's even worse.

Erica Pandey, author of @Work
6 hours ago - Economy & Business

The limits of Biden's plan to cancel student debt

Data: New York Fed Consumer Credit Panel/Equifax; Chart: Axios Visuals

There’s a growing consensus among Americans who want President Biden to cancel student debt — but addressing the ballooning debt burden is much more complicated than it seems.

Why it matters: Student debt is stopping millions of Americans from buying homes, buying cars and starting families. And the crisis is rapidly getting worse.