The COVID-19 pandemic continues to have a massive impact on Americans’ mental health. Another related crisis will worsen in the short term and have profound implications going forward: Older adults in America are facing a mental health crisis due to lack of access to Medicare providers.
Currently, licensed marriage and family therapists and licensed mental health counselors are qualified to provide counseling services and are already an integral part of the mental health-care delivery system in the U.S. All 50 states issue these licenses. These professionals are recognized as eligible providers by Medicaid and private insurance plans.
Both licensed mental health counselors and marriage and licensed family therapists are highly trained to diagnose and treat mental disorders including anxiety, depression and trauma. Nevertheless, these practitioners are sidelined in the Medicare program because of antiquated laws and regulations. To date, Congress has failed to designate these licensed counselors as eligible Medicare providers, preventing them from helping older adults and families through the program.
The solution is simple: Congress should pass the Mental Health Access Improvement Act (H.R. 432 and S. 828), legislation that would make over 200,000 licensed mental health counselors and marriage and licensed family therapists eligible to treat seniors. The Mental Health Access Act would allow these counselors to bill Medicare for medically necessary behavioral health services in order to treat seniors and individuals with Medicare-approved disabilities.
Older adults are extremely vulnerable to the mental health impacts of the pandemic. The Centers for Disease Control and Prevention estimates that 20% of adults over the age of 55 are suffering from mental health issues. Millions more likely go undiagnosed.
The National Academy of Medicine has found that fewer than 40% of older adults with mental health disorders receive treatment. The stress and loneliness caused by the pandemic are driving up rates of depression and anxiety among older adults, and Medicare needs thousands of new providers to meet this unprecedented need.
Medicare enrollment is expected to skyrocket in the coming years, with 80 million Americans projected to be in the program by 2030. This growth will further burden an already overtaxed system that is failing to provide mental health services to its beneficiaries. The pandemic has hastened this outlook.
We need many more mental health providers to be made available to see Medicare beneficiaries. Access to treatment for Medicare beneficiaries is especially lacking in rural areas. Over 125 million people in the U.S., more than one-third of all Americans, live in what are called mental health professional shortage areas, according to the Health Resources and Services Administration.
Licensed marriage and family therapists and licensed mental health counselors are much more likely to be in these rural areas than any other practitioner. According to the Washington, Wyoming, Alaska, Montana, Idaho (WWAMI) Rural Health Research Center at the University of Washington, there are twice as many licensed marriage and family therapists and licensed mental health counselors in rural counties as social workers, six times the number of psychologists, and 13 times the number of psychiatrists. About one-fifth of Medicare beneficiaries live in rural areas, and the lack of access to mental health providers is leaving them with nowhere to turn.
Together, the licensed mental health counselors and marriage and family therapists make up 40% of the mental health workforce. Adding these licensed counselors and therapists as Medicare-eligible providers would go a long way in addressing the shortages in Medicare’s mental health workforce and preparing for increasing demand for these services from Medicare beneficiaries in the future.
Congress should pass the Mental Health Access Improvement Act.