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05/26/2024 07:44 PM
Pennsylvania House of Representatives
https://www.legis.state.pa.us/cfdocs/Legis/CSM/showMemoPublic.cfm?chamber=H&SPick=20230&cosponId=41176
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House of Representatives
Session of 2023 - 2024 Regular Session

MEMORANDUM

Posted: July 13, 2023 12:43 PM
From: Representative Kevin J. Boyle
To: All House members
Subject: Expanding Access to Mental Health Medications
 
Mental health is just as important as physical health. For many people, medications are a vital tool in managing their mental illness—just like how medication is a vital tool to manage high blood pressure or cholesterol.
 
Sometimes things get in the way and keep people from accessing their mental health medications. Step therapy can be one of those barriers. Step therapy is a health insurer’s requirement that you try one, two, or  three (usually cheaper) medications before insurance pays for the medication your doctor initially prescribed.
 
Think about what step therapy actually means for people living with a mental illness:
  • Since mental health medications are designed to affect someone’s mind (unlike physical health medications for, say, high blood pressure or cholesterol), it means a mental illness must not improve or must get worse before a patient moves on to the next “step.”
  • It means a person must risk or go through terrible side effects like suicidal thoughts, mood changes, nervousness, dizziness, upset stomach, headaches, and more.
  • It means other areas of life—like a person’s work and social life—are negatively affected because of the side effects and changes in their mental state.
Moreover, studies show that step therapy on mental health medications is associated with decreased medication adherence and increased spending on hospital care, emergency room care, and incarceration.
 
In light of all of this, I will be proposing a law that expands access to mental health medications by eliminating multi-step step therapy on those medications.
 
Last year we passed Act 146. That law requires health insurers to “consider” step therapy exception requests. My bill does not touch that exception process. Instead, my bill outright eliminates multiple-step step therapy on mental health medications. In so doing, my bill will reduce barriers and make it easier to access mental health treatment.
 
At least four other states restrict step therapy for mental health medications in private insurance contracts. At least four more states have pending legislation on the topic. Pennsylvania can be a leader in promoting mental health by passing this bill.
 
I hope you will join me in expanding access to mental health medications by supporting this bill.