Senators say they are optimistic that a bipartisan mental health reform bill can reach the Senate floor and pass soon, though they are still working out differences over guns and finances.
Multiple senators said Majority Leader Mitch McConnell (R-Ky.) has told them that he is willing to put the bill from Sens. Chris Murphy (D-Conn.) and Bill Cassidy (R-La.) on the floor but that a consensus has to be built ahead of time so that consideration does not take up too much valuable floor time.
“Senator McConnell has said that if we can resolve, if we can find a consensus among ourselves and reduce the amount of time it takes to put it on the floor, that he will interrupt the appropriations process, put it on the floor, try to get a result this year,” Sen. Lamar Alexander (R-Tenn.) said on the Senate floor.
Alexander said he is “very hopeful” that the bill could get on the floor in June.
Cassidy and Murphy held a summit Thursday during which advocates unveiled over 200,000 signatures on petitions pushing for passage of the bill.
One obstacle continues to be gun politics. Sen. John Cornyn (R-Texas) is seeking to include gun-related language from his own mental health bill that Democrats have objected would make it easier for mentally ill people to get access to guns.
But Alexander, Murphy and Cassidy say they are working with Cornyn to try to reach an agreement, and Cornyn himself has said repeatedly that he wants to work with others to get to a result.
{mosads}The other main obstacle is funding. Murphy and Cassidy’s bill currently does not include any new funding for mental health programs, but the Finance Committee is working to find offsets for funding provisions that could be added in.
One option is to use new funding for expanding a program from Sens. Debbie Stabenow (D-Mich.) and Roy Blunt (R-Mo.) that would set up urgent care mental health clinics in more states.
“Senator Cornyn wants to see a result, too, so he and Senator Murphy and Blunt, Stabenow, Cassidy, everybody is working in good faith to try to minimize the differences and see where we can get a consensus,” Alexander told reporters Thursday. “I’m optimistic that we will.”
Murphy said that Alexander has been talking to McConnell about the path forward, including “how the Cornyn bill gets integrated.”
“[McConnell] wants to bring this bill to the floor, but we have to have a time agreement,” Murphy said after the summit. “It’s hard to have a tight time agreement if we’re going to debate mental health and guns at the same time. And so that’s what we’re trying to work out.”
On the funding side of the question, Murphy said he is “very encouraged” by the Finance Committee’s work to find offsets for new mental health spending.
Besides the Blunt-Stabenow provision on clinics, another option for new funding would be to free up Medicaid to pay for more care at mental health facilities, rolling back something known as the “IMD exclusion.”
But that would be more expensive than the Blunt-Stabenow provision.
“There’s going to be a limited amount of money available for our bill once it hits the floor, and the question will be whether it will be allocated to eliminating the IMD exclusion or expanding out the Blunt-Stabenow program,” Murphy said. “That’s a decision that in some ways is a little bit above our pay grade.”
“The IMD exclusion is expensive,” he added. “Expanding out the Blunt-Stabenow proposal is not as expensive, so that gives you a little bit of a hint about what might be more possible on the floor.”
The House is also working on a mental health bill, which is expected to get a markup in committee in June.
The underlying Murphy-Cassidy bill authorizes grants for topics like integrating physical and mental health services, though the amounts of funding will depend on the appropriations process. It also seeks to strengthen enforcement of “parity” laws that require that insurance companies cover mental health services just as much as they cover physical health services.