Proposed Changes to Medicare Would Weaken Access to Mental Health Drugs

This post originally appeared in The Columbus Dispatch on February 29, 2021.
​
During the early days of mental health treatment, asylums often restrained people who had mental illnesses with iron chains and shackles. As better understanding and treatments developed, this cruel practice finally stopped.

In the early 1950s, Mental Health America issued a call to asylums across the country for their discarded chains and shackles. In 1956, the chains and shackles were melted down and recast into a sign of hope – a 300-pound Mental Health Bell that now serves as a powerful reminder that the invisible chains of misunderstanding and discrimination continue to bind people with mental illness. Now, the Mental Health Bell rings out hope for improving mental health and achieving victory over mental illness.

Mental Health America of Ohio advocates for public policies that help people with mental illness. And sometimes we need to clang an alarm bell when proposed laws and regulations present barriers to mental health patients seeking treatment. This is, unfortunately, one of those times.

Today, we sound the alarm on a recent proposal that threatens to harm patients with mental illness who depend on Medicare Part D. In the final hours of the Trump Administration, the Center for Medicare and Medicaid Innovation (CMMI) proposed a series of modifications to Part D’s formulary requirements through the Part D Payment Modernization Model.

While the proposed changes aim to lower health care costs for the government, the proposal sacrifices far too much in the name of savings by targeting the “six protected classes” of prescription drugs — a decision that endangers the lives of Americans suffering from mental illness.

Under current law, each Medicare Part D plan is required to cover “all or almost all” medications within six classes of prescription drugs. These “protected” types of medication — which include anti-psychotics and anti-depressants — ensure that Americans struggling with chronic, difficult-to-treat conditions receive the health care they need.
Throughout the United States, individuals suffering from mental illness rely upon these patient protections to safely manage their treatment plans. But now CMMI’s proposal would slash those protections and weaken access to medication.

The recently proposed health care model would require that Medicare Part D formularies cover only one drug per each of the six protected classes. As a result, many Part D plans could drop medications essential to specific treatment plans, forcing patients to accept — and doctors to prescribe — potentially subpar alternatives.

For those struggling with mental illness, such policy changes could be devastating, and it would not lower costs for patients. Not only would it create instability and unnecessary stress in the lives of these individuals, but it also could threaten to upset the delicate chemical balance that these people strive to maintain. And when that happens, the consequences can be deadly serious.

When it comes to helping those who struggle with mental illness, there is no question that America has come a long way. From restraining people with iron shackles to ensuring they receive the medications they need, our nation has made tremendous progress in addressing mental health.

We just cannot afford to go backward — and yet the proposed changes to the six protected drug classes would do precisely that. The Medicare Part D model sacrifices access to lifesaving anti-depressants and anti-psychotics in pursuit of health care savings. In short, it deprioritizes the mental health of Americans at a time when they need support most, and that is simply unacceptable.

Kenton Beachy is executive director of Mental Health America of Ohio and has more than 25 years of experience in nonprofit management, with nearly 20 years in behavioral health.