New York targets mental health insurance denials

Insurance companies offering plans in New York could soon be barred from denying coverage for critical mental health services under a new proposal from Gov. Kathy Hochul.

The policy, which was included in the governor’s 2023 State of the State priorities last month, aims to prohibit insurers from denying access to “medically necessary, high-need, acute, and crisis mental health services for both adults and children.” The governor’s plan would also help patients access better private and Medicaid coverage for mental health services, as well as have an easier time making appointments in more regions. The latter would ensure patients can get behavioral health services from in-network providers.

The proposal still requires legislative approval, but it comes as Hochul and New York City Mayor Eric Adams both look to improve behavioral health access in response to homelessness, children’s school performance, and public safety-related concerns.

More details—like exactly what services must be covered and how much it could cost—are expected to come Wednesday as Hochul unveils her budget plan for the fiscal year, which begins on April 1.

The governor has argued that “fixing New York’s mental health care system is essential and long overdue.” Demand for behavioral health services spiked in the wake of the Covid-19 pandemic, though many New Yorkers “struggle with finding providers in their health insurance plan’s network,” according to the state’s Office of Mental Health.

“The barriers are seemingly endless. No appointments available close to home. Insurance won’t cover care. Long waits for psychiatric beds in hospitals. As a result, people have been forced to suffer in silence,” she said during her State of the State remarks on Jan. 10. “We have underinvested in mental health care for so long, and allowed the situation to become so dire, that it has become a public safety crisis as well.”

But some insurers have already started to question the governor’s proposal and what it could mean for healthcare costs.

The New York State Conference of Blue Cross and Blue Shield Plans (NYSCOP), which provides health coverage to nearly six million New Yorkers, cast it as “another ‘business as usual’ mandate on private insurance” and argued the policy could drive up costs for enrollees.

“As New Yorkers continue to struggle with the ever-increasing cost of coverage, we are especially sensitive to additional mandates, which place premiums out of reach.We support broad access to mental health care, but this proposal appears unnecessary,” the group said in a statement. “New Yorkers already have the broadest mental health coverage in the country because of the [state’s] most robust mental health parity laws in the nation.”

NYSCOP added that it looks forward “to seeing the details of this measure and to working with the governor over the coming months to ensure that this and other proposals do not lead to further increases in the cost of coverage for average New Yorkers.”

Meanwhile, Eric Linzer, president and CEO of the New York Health Plan Association, said his organization also wants to learn more about the governor’s proposal.

“We share the governor’s commitment to ensure every New Yorker has access to affordable, effective, and equitable mental health support and counseling,” he said in a statement. “Health plans take seriously their obligation to ensure members have access to the care they need, offering a broad range of services to support members, and we look forward to further details on her proposals to expand behavioral health services in New York.”