What to Expect for Behavioral Health in 2020

From funding for Certified Community Behavioral Health Clinics to state Medicaid waivers, 2020 is sure to be a whirlwind for behavioral health and for the health care system at large. While Congress remains split down party lines with Democratic control of the House and Republican control of the Senate, time will tell if any large changes will happen during this election year. Here is a preview of what is likely ahead in health policy in the first year of the new decade.

Certified Community Behavioral Health Clinics (CCBHCs): In 2019, federal leaders from both parties in Congress and the Trump Administration demonstrated support for the eight-state demonstration program that has increased access to addiction and mental health treatment across the country. Originally set to expire on June 30, 2019, the CCBHC demonstration received four funding extensions last year to continue the program with the latest now expiring in May this year. In 2020, the National Council and its advocates will work diligently to build further support for CCBHCs with the goal of passing the Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/ H.R. 1767). The bill would extend the CCBHC demonstration for another two years and add eleven more states that applied for the program but were not originally selected.

Election 2020: With the first presidential primaries and caucuses kicking off next month, campaigns are well underway with a few candidates promoting their mental health and addiction policy platforms in New Hampshire last month. As Senators and Representatives on both sides of the aisle gear up for their own reelections, the legislative tempo in Washington is likely to slow down until the 117th Congress convenes in 2021.

Mental Health First Aid: 2019 marked the 2 millionth person in the US trained in Mental Health First Aid, a course that teaches attendees to identify, understand and respond to signs of mental illnesses and substance use disorders. Mental Health First Aid will be rolling out brand new curricula in the coming weeks to continue growing the program and its reach. States across the country will also be working to pass legislation to make Mental Health First Aid courses more accessible for certain populations through proposals such as requiring law enforcement personnel and teachers to receive the training to better serve their communities.

Addressing Rising Health Care Costs: Congress has continued efforts to address the rising costs of health care in this country, including some legislative movement on issues like increasing transparency across the health care field, creating out of pocket spending caps for Medicare.

State Medicaid Waivers: The Centers for Medicare and Medicaid Services (CMS) under the Trump Administration has often focused on providing states more options to tailor their public health coverage programs. In 2020, CMS will continue negotiating with states to approve and implement waivers that include provisions such as overriding the institutions for mental disease (IMD) exclusion in Medicaid, enforcing the federal mental health parity law, incorporating alternative payment models, implementing work requirements for Medicaid enrollees, and funding their Medicaid programs via block grants.

Health Reform: Although there will likely be minimal legislative changes regarding the Affordable Care Act if any in 2020, the ACA still winds its way through the judicial system. Just last month, a federal appeals court ruled that the individual mandate that every American carry health insurance is unconstitutional. Now lower courts must decide if the rest of the law can stand without the individual mandate.

Stay tuned each week to Capitol Connector for the latest updates as each of these policy stories develop throughout the year.