Conference Round Up  

PCG staff shares insights from additional conferences in another round up this month. This article includes key highlights from conferences we have attended on a range of health policy topics. Keep an eye out for additional updates from upcoming conferences we will be at later this fall.  

National Alliance on Mental Illness 

PCG was invited to attend the 2024 NAMI Partner Summit as a result of our volunteer initiatives and commitment to behavioral health improvements. This event focused on NAMI’s advocacy and research priorities, and provided a deep dive into the policy updates that NAMI has been actively involved in shaping. NAMI’s mission is to provide advocacy, education, and support to those affected by mental illness, working toward a world where mental health is valued equally with physical health. The Partner Summit was an excellent opportunity to learn about the real, positive changes emerging from NAMI’s efforts to drive mental health innovations and improve the well-being of Americans.

At the Partner Summit, NAMI’s team outlined the following policy updates:

Consolidated Appropriations Act of 2024

The Consolidated Appropriations Act of 2024 included increased funding  to enhance crisis services, mental health research, and support for veterans:

• • • 988 Suicide & Crisis Lifeline: $519.6M (+$18M)
    • National Institute of Mental Health (NIMH): $2.18B (+$75M)
    • VA Mental Health & Suicide Prevention Programs: $16.24B (+$2.34B)

Medicaid and Incarceration Reforms

There have also been recent changes to ensure continuity of care for individuals transitioning out of incarceration, ensuring that mental health services are accessible during reentry, reducing recidivism rates for individuals with mental health challenges. The Consolidated Appropriations Act of 2023 requires states to suspend, rather than terminate, coverage for incarcerated individuals. This change, effective January 2026, includes $135M in grants to states.

Additionally, a new Medicaid waiver option allows for the provision of health care supports up to 90 days before release from incarceration, ensuring smoother transitions back into the community. Four states have been approved, with 19 pending.

Two other legislative proposal remain pending:

• • • The Reentry Act, which seeks to restore Medicaid coverage up to 30 days before release
    • The Due Process Continuity of Care Act, which seeks to extend coverage to pretrial detainees.

988 Implementation Act

The would enable the implementation of a 988 Line and provides funding, helping to meet a community need and improve crisis response systems. Specifically, the Act:

• • • Requires that calls are routed based on caller proximity, rather than area code, to improve service accuracy.
    • Secures ongoing funding for regional and local 988 call centers, crisis workforce development, and public awareness campaigns.

Mental Health Parity Updates

In 2023, the Biden Administration’s finalized the   to improve the enforcement of mental health and substance use disorder (MH/SUD) parity.

Other Recent Legislation of Note

• • • This bipartisan Kids Online Safety Act would create tools for parents to protect their children’s online experiences and holds platforms accountable for harmful content.
    • The Safe Step Act would bring transparency to step therapy protocols, requiring insurers to create an exception process and placing limits on delays in accessing treatments.

University of New Hampshire Health Law and Policy Annual Symposium  

As it does each fall, the Institute for Health Policy and Practice at the University of New Hampshire (UNH) hosted a Health Law and Policy Symposium in September. The event brought together state regulators, policy experts and advocates, providers, and insurers to hear from state and national experts. The symposium focused on needs and opportunities to improve healthcare access, affordability and equity. While speakers focused on the New Hampshire landscape, the information is certainly meaningful for states across the country. 

A key theme that resonated throughout the day was that all of the issues of focus need attention. Access to coverage and care is not meaningful if it is not affordable or equitable. Solving for one problem does not ameliorate the challenges in the system broadly. 

Access 

Deb Fournier, the Institute’s Director of Health Law and Policy noted that New Hampshire has made significant headway in expanding access to coverage, with the state’s uninsurance rate down to approximately five percent. However, along the theme of intertwined challenges, she and other speakers reiterated throughout the day that access to coverage does not necessarily equate to access to healthcare. Rachel Block from the Millbank Memorial Fund noted that many privately-insured individuals in the state – including those with employer-sponsored insurance – have high deductibles that act as barriers to care. Many small employers in the state have had to increasingly turn to cost-sharing as a lever to address the rising costs of coverage. Sherri Simmons-Horton from UNH also acknowledged that having an insurance card may not provide everyone with access to care given the barriers to equity in our healthcare system, as expanded on below. 

Danielle Hernandez from the New Hampshire Department of Health and Human Services Health Professions Data Center and Marcy Doyle from UNH also addressed the impact of workforce challenges on healthcare access, especially in the state’s rural western and northern geography. They particularly emphasized the role of advance practice practitioners – physician assistants (PAs) and advance practice registered nurses (APRNs) – in solving that issue. They noted that long wait times create barriers to accessibility and that PAs and APRNs in the state have shorter wait times and fewer practitioners nearing retirement age. However, the lack of a robust Graduate Medical Education program for PAs and APRNs stand in the way of growth of those professions, with provider organizations bearing the cost of training. Marcy Doyle advocated for this as a key opportunity to expand the workforce and access. 

Affordability 

As cost centers of the healthcare system tend to point to one another as the priority for cost containment efforts, Deb Fournier shared data from the Centers for Medicare and Medicaid Services Office for the Actuary that can help New Hampshire and other states understand where to focus efforts. Interestingly, the data showed that while hospitals are the largest piece of the healthcare cost pie, spending on prescription drugs is rising at the fastest rate. More broadly than prescription drugs, the rate of growth has slowed. However, Fournier stressed that a slowed rate of growth does not impact the fact that costs are already unaffordable and continue to grow.  

A participant in the symposium noted that cost is equal to price times utilization – however, much of the efforts to control cost to-date has focused on utilization (such as utilization management techniques). He urged the participants to focus on price to make headway on affordability in a way that the focus on utilization has not. 

Equity 

Sherri Simmons-Horton, a qualitative researcher from UNH, shared poignant stories of the existence and impact of inequities in the healthcare system. She noted that people of color have the highest mortality and infant mortality rates, members of the LGBTQIA+ community often face insensitivity in the care system, influencing them to delay care, and foster care youth often face delays in care due to their lack of consistent support and inherent transient nature. Simmons-Horton encouraged participants to be mindful of the outcomes that come from inequities and stressed that it is a “system problem” not a “people problem.” She also shared her view that fixing inequities is more about addressing “how we do the work” and how services are provided, rather than making policy changes.