Lawmakers Push to Reduce Mental Health Care Costs for TRICARE Users

Washington, D.C.Image via Pixabay

WASHINGTON, D.C. — U.S. Representatives Chrissy Houlahan (D-PA-06) and Guy Reschenthaler (R-PA-14), along with U.S. Senator Bob Casey (D-PA), are spearheading efforts in Congress to lower the costs associated with behavioral and mental health care services for Americans utilizing TRICARE. The Stop Copay Overpay Act, a bipartisan and bicameral initiative, aims to cap out-of-pocket expenses for mental health outpatient visits, ensuring these costs do not surpass copays for primary care visits.

This legislative measure is anticipated to reduce the cost of behavioral and mental health visits by an average of 48%, based on current TRICARE plans. Senator Casey introduced the bill in the U.S. Senate on Wednesday.

“As a veteran, I’ve seen too many brave men and women struggle to access the mental health care they need and deserve. It’s not right. Mental health care is health care, and creating cost parity between primary care visits and behavioral and mental health visits would be one giant leap forward in ending the stigma to seek treatment,” said Rep. Chrissy Houlahan. “I’m proud to partner with fellow Pennsylvanians Rep. Reschenthaler, a veteran, and Senator Casey, a longtime champion for Pennsylvania’s veterans, to introduce our Stop Copay Overpay Act. This bipartisan bill will ensure that our military families under TRICARE can access affordable mental health care. After all they have done for this nation, they deserve nothing less.”

Initially introduced in 2021 by Representatives Houlahan and Reschenthaler, the Stop Copay Overpay Act has seen progressive development. It was successfully incorporated into the House-passed National Defense Authorization Act this year. Senator Casey is now advocating for the bill in the Senate.

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“We can never fully repay our servicemembers and their families for their sacrifice, but we can, and we must, ensure that they get the health care they deserve. This bill will ensure that members of the military, veterans, and their families pay the same amount for mental health care as they do for any other doctor’s visit,” stated Senator Casey. “Military servicemembers paid the price to defend our Nation; now we must make sure that they can take care of their health and wellbeing.”

Copays for behavioral and mental health services nearly doubled in 2018, following the reclassification of these visits as specialty care. The COVID-19 pandemic further highlighted the necessity of accessible mental and behavioral health services for service members and their families, who often faced isolation and heightened stress during lockdowns.

Currently, TRICARE serves over 9 million individuals nationwide, including more than 160,000 Pennsylvanians. It covers a range of services such as individual and family therapy, substance abuse treatment, eating disorder treatment, psychological testing, and behavior analysis. High copays can discourage individuals, particularly retirees on fixed incomes, from seeking essential mental or behavioral health care.

By addressing this critical issue, the Stop Copay Overpay Act aims to ensure that those who have served the nation can access the mental health support they need without financial barriers.

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