By Anthony Caliano
The Intent of HB1980 was to improve patients’ mental health by authorizing insurance reimbursement for telephonic treatments. Special interests got their own version of the bill through conference committee, which, if passed, would have been disastrous for the people of Hawai’i.
June 27th marked a major victory for consumers of mental health counseling in Hawaii. In announcing his reasons for including HB1980 on his “Intent to Veto” list, the Governor put the interest of people’s health over the financial interests of private health insurance companies seeking to exploit disadvantaged consumers of mental health services – to save a buck – amidst one of the worst mental health crises in American history.
It was clear at the June 27 press conference, when discussing his objections to this “antitelehealth bill”, that Ige listened to actual community members and care providers. (Rather than the health insurers, who are not actual health care providers.) If HB1980 passed, it would be providers, rather than the insurers, who would need to explain to their patients why their telephonic counseling sessions are no longer covered by insurance, unless the following criteria are met:
- Audio/Visual Telehealth technology must be unavailable;
- The patient must first see the provider in person within the past year; and
- The telephonic treatment must be a “covered health care service.”
These burdensome conditions are not fair to the many disenfranchised groups this bill would impact.
Kupuna are already on edge due to their heightened risk of COVID-19 complications. It is
unacceptable to then take away their preferred, simplest, and most accessible mode of communication – the standard telephone – as a means of receiving treatment from their mental health specialist is.
Rural residents simply do not have the same telecom infrastructure as residents of Kaka’ako.
The economically disadvantaged can’t afford smart devices and highspeed broadband. Perhaps those hurt the most are those with limited technological or language proficiency.
All of these people in crisis would have been left behind by this legislation.
This bill is also unfair to every American taxpayer. Why? Because on the federal level, the Centers for Medicare and Medicare Services decided that telephonic and audio-only communications qualify as “telehealth” for mental health services – without requiring patients to physically visit their provider AND lack a smartphone. If HB1980 passed into law, your hard earned private employer-sponsored health plan coverage would give you and your family materially inferior care options than those with Medicare/Medicaid plans – BELOW the Federal safety-net. Those on Medicaid can use the telephone to talk to their therapist.
Those with private plans in Hawaii could not. Why shouldn’t we, Hawaii residents and private consumers of health insurance plans, have that choice? If Hawaii’s private insurance marketplace offers it – as some plans have for years – why is our state government trying to take it away?
The Federal government is actively taking steps to advance access to telehealth, but our State seems to be going backwards. Why should we, as consumers, pay for private health insurance plans whose executives are lobbying to pass laws that harm us?
How irresponsible is our government when the Chair of the House Health Committee, who introduced this bill, was unable to provide concrete answers to the press about the questions raised by this bill. He instead referred the Star-Advertiser to
direct their questions to HMSA. (Check out the article here.)
The Health Committee Chair also explained to Hawaii’s Mental Health Task Force that because Hawaii’s Medicaid/MedQuest Administrator did not like the senate version of HB1980 that went to conference (which harmonized state and federal telephonic/telehealth law), the conference committee passed out a final draft that actually legally conflicted with federal law. Moreover, that final draft was significantly more lucrative for Hawaii’s private insurance plans. My questions, as a private citizen are: “Who elected the MedQuest Administrator?” and “Why does the government have its hands on my private mental healthcare?” This 11th hour legislation served yet another special interest that writes sweetheart donation checks – to ensure their lackeys can stay in power another term.
We now find ourselves in another election year – and since the last election, we have only seen homelessness get worse, domestic violence go through the roof, and countless neighbors struggle with addiction, anxiety, depression, and attempted suicide. Knowing this bill would affect every single private health care plan in Hawaii, it’s troubling to consider how many more lives would have been endangered or lost as a direct or indirect result of HB1980’s passage.
Thus, the timing of this bill – “Relating to Telephonic Services” – under a pretense that it would provide relief during the pandemic, is fishy too. Most people learning about a new “Telehealth” bill would not have suspected a callous, opportunistic piece of legislation when people were in crisis. Yet, it nearly made it under the Governor’s pen before we, the people, were able to put a stop to it. Fortunately, through media activism, hundreds of health care providers and private citizens wrote to the Governor asking for this veto. Thankfully, he agreed.
The fight for telephonic telehealth legislation that actually helps, rather than hurts people will live on another year – to a newly elected legislature and Governor.
Mental Health is a concern for everyone. During this heated primary election season, every candidate gave lip service to mental health access. Their advisors made sure of that. But it’s important to see through the clown shows and understand what is at stake.
This election season, it is our Kuleana, as responsible citizens, to weed out the elected officials we hired – through our ballots and taxes – who’ve shown us they only seek power and influence by serving special interests. Don’t let them chip away at our mental health – as it can only get worse from there.