Summary#
This bill would change how Medicaid pays for increases in state spending on behavioral health services (including mental health and substance use services). For any calendar quarter, the federal government would pay 90 percent of the amount by which a State's spending on those services exceeds a baseline amount based on a corresponding quarter in the 4-quarter period ending March 31, 2019. States must meet conditions to get the extra federal funds, including rules to ensure the funds supplement, not supplant, state funds that were in effect on April 1, 2021, and that the funds are used to improve capacity, efficiency, and quality of behavioral health services (for example, higher provider payment rates or measures to reduce staff turnover).
The bill directs the Secretary of Health and Human Services to issue sub-regulatory guidance within 180 days after enactment defining which services count as behavioral health services for this purpose. The higher federal matching rate would apply to calendar quarters beginning on or after January 1 of the year that begins one year after the date of enactment. The bill also requires the Secretary to report to congressional committees no later than one year after enactment and annually after that on payment rates, the reasons for those rates, and utilization of behavioral health services under Medicaid, as data are available.
What it means for you#
- If your state increases Medicaid spending on behavioral health services above the bill's baseline, the state could receive a higher federal match (90%) for that increased spending.
- States must keep or increase their own funding levels in place as of April 1, 2021, and use the extra federal funds to improve how behavioral health services are provided, not to replace existing state dollars.
- The bill does not itself change which individuals are eligible for Medicaid or guarantee specific services; it changes the federal matching rules for certain increased spending.
Expenses#
- The bill sets the federal matching rate for qualifying increases at 90 percent of the increase amount.
- The baseline for comparison uses the corresponding quarter in the 4-quarter period ending March 31, 2019.
- The bill does not include any estimate of total federal or state costs or savings. No publicly available information on estimated budgetary effects is included in the bill text provided.
Proponents' View#
- The bill aims to encourage states to increase Medicaid spending on behavioral health services by offering a higher federal match for the added spending. It requires the extra funds be used to expand capacity, improve quality and efficiency, raise provider payment rates, and reduce staff turnover.
Opponents' View#
- No publicly available information on opponents' views or objections is included in the bill text provided.