New Hampshire House again puts off wraparound mental health bill

New Hampshire House lawmakers on Thursday balked at requiring insurers to cover wraparound mental health services. The vote to send the bill to interim study was a blow to Gov. Kelly Ayotte, who has been a vocal supporter of the legislation and blasted insurance companies for their opposition.

Wraparound services seek to connect disparate and complicated care systems, such as mental healthcare, child protective services, and special education to work together seamlessly for people in a mental health crisis. Senate Bill 498 would’ve required insurance companies to cover FAST Forward, a state-run program that offers wraparound care for New Hampshire children. It also would’ve created a board tasked with assessing fees on companies in order to fund the care. The bill was approved by the Senate in March, and Ayotte has been pressuring House lawmakers to send it to her desk. However, lawmakers bucked that pressure Thursday and voted, 188-164, to send the bill to interim study, a move that sidelines the effort for at least another year.

Advocates of the legislation argued it’s necessary both because it’s beneficial for children with mental health challenges and because it saves the state money. They said the wraparound services help children deal with mental illness before the challenges escalate into a more severe crisis that requires expensive state intervention, such as psychiatric hospitalization.

“Imagine being a parent with a serious mental health crisis,” Rep. Jared Sullivan, a Bethlehem Democrat, said on the House floor. “You would naturally contact your doctor or your insurance company to see what your options are. You would never hear about the FAST Forward program. … Too often families do not gain access to those services until their child deteriorates until hospitalization becomes necessary, often at a cost of six figures.”

Opponents argue that insurers already offer mental healthcare, just not FAST Forward or another wraparound service. They also take issue with the board assessing fees, a measure some have likened to a tax on insurance customers.

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“This is a cost-shifting bill that basically says, ‘Rate payers: you’re not taxpayers,” Rep. John Hunt, a Rindge Republican who chairs the Commerce Committee, said. “‘So therefore, we’re gonna save taxpayer money by making you pay for the FAST Forward program for all kids.”

Hunt encouraged his colleagues to vote for interim study “if we would like to go home at a reasonable hour and not sit here and debate over and over all these other amendments.” He said the Legislature needs another year to “sort this out.”

However, the issue has been a perennial debate in the State House, including last year, when Senate Bill 128 failed to advance. 

This year, when the House Commerce Committee voted to recommend sending SB 498 to interim study, Ayotte weighed in on the debate, saying she was “incredibly flabbergasted and disappointed.” The first-term Republican governor launched into a pressure campaign to keep the bill alive. She argued insurance companies, which have strongly opposed the measure on grounds that it will force them to increase premiums, were negotiating in bad faith and “stalling because they don’t want to cover mental health coverage for children, and it’s wrong.”