Mental health exam mandates back on the table after 2020 bill died under veto threat

Rep. Michaelson Jenet says she has struck a compromise with Gov. Polis

By: - May 14, 2021 5:00 am
Brianna Titone and Dafna Michaelson Jenet

State Rep. Dafna Michaelson Jenet, right, speaks on the steps of the Colorado Capitol Building, with Rep. Brianna Titone, left, during a news conference May 12, 2021. (Faith Miller/Colorado Newsline)

Last year, soon after the onset of the COVID-19 pandemic, Gov. Jared Polis warned legislators he’d veto future bills requiring health insurance companies to cover additional services. New mandates could result in higher premiums, he warned.

Under threat of the governor’s veto, a 2020 bill that would have required insurance to pay for a yearly mental health exam — in the same way it would cover a physical check-up — died in a Senate committee.

Now, Rep. Dafna Michaelson Jenet, the Commerce City Democrat who sponsored the bill last year, is bringing back a new version. Jenet said she has the governor’s support this time.


“We worked very closely with the governor and the commissioner of insurance ever since it didn’t make it past the finish line last year,” she told Newsline. “This bill strikes that compromise.”

Rep. Brianna Titone, an Arvada Democrat, is working with Jenet on House Bill 21-1068 this year. The bill’s Senate sponsor is Sen. Dominick Moreno, a Democrat from Commerce City.

Starting in 2022, HB-1068 would require insurance plans purchased by large employers to cover an annual mental health exam of up to one hour, performed by a qualified mental health provider. The exam would have to comply with federal law mandating comparable coverage, or parity, between physical and behavioral health. Insurers could not charge patients deductible costs, copayments, or coinsurance for the mental health exam.

An amendment in the bill’s first committee hearing would mean that the requirements wouldn’t kick in for individual and small-employer plans until 2023.

HB-1068’s supporters say that despite parity laws at the federal and state level, insurance plans currently don’t cover mental health check-ups that are on par with the yearly required physicals.

The Colorado Medicaid Behavioral Health Network, or COMBINE — which represents therapists, counselors and addiction specialists who serve Medicaid patients — is vouching for HB-1068. Mental health screenings by primary care providers don’t always work for identifying illnesses such as depression or post-traumatic stress disorder, COMBINE pointed out in a statement.

The bill’s supporters say that insurance plans currently don’t cover mental health check-ups that are on par with the yearly required physicals.

In contrast, an annual exam conducted by a mental health professional “could include a report of symptoms, family history, an addiction screen, disordered eating screen, attachment inventory, (Adverse Childhood Experiences) measure, a PTSD scale including sexual assault, domestic violence, racial trauma, workplace history, justice involved trauma, and medical and dental trauma histories, and an anxiety scale,” the statement said.

The yearly exam would also provide an opportunity for “psychological education,” COMBINE added.

HB-1068 would not apply, however, to people on Medicare, Medicaid, military plans, or self-insured employer-based health plans, which the federal government regulates. Medicaid patients already have similar benefits, Michaelson Jenet said.

The bill would apply to the approximately 1 million Coloradans who either buy individual or small-employer insurance plans through Connect for Health Colorado, the state’s health insurance marketplace, or who get their insurance through a large employer, unless the employer is self-insured.

HB-1068 passed the House Health and Insurance Committee on May 5, by unanimous vote, and is set for a hearing in the House Appropriations Committee on May 14.

Last year, Polis’ veto warning came in the form of an April 2020 statement he released after signing a bill requiring coverage of infertility treatments.

In the statement, Polis said he signed House Bill 20-1158 “for the compelling reasons articulated by the sponsors and advocates for this bill,” which included helping women who are unable to get pregnant but couldn’t afford treatment that would help. But he added a caveat.

“Additional mandates, which may, by themselves, be important advancements in expanding coverage or reducing long term costs, often do not meet the second goal of lowering health insurance costs for people today, and can have the unintended consequence of making coverage less accessible to those who need it most,” Polis said. “I will not sign any other insurance mandate bills passed by the General Assembly during the 2020 session except where there is an urgent need for additional benefits related to COVID-19.”

Polis added that he would only sign bills with new insurance mandates after 2020 if the bills included language protecting the state’s general fund from “unanticipated costs,” and only if lawmakers provided “substantial and documented” evidence including an actuarial analysis to show the legislation would save people money on health care.

Less than two months after Polis released that statement, in late May 2020, the Denver Post reported that the sponsors of last year’s mental health exam bill faced opposition from the governor’s office on the grounds that it could increase insurance costs. The Senate Appropriations Committee postponed the bill indefinitely on June 10.

As for HB-1068, “The bill is still working through the legislative process and we are still engaging with the bill’s sponsors,” Polis spokesperson Shelby Wieman said in an email Wednesday.

Michaelson Jenet said she’s been working with the governor’s office and the state insurance commissioner to craft the legislation. An analysis shows the bill would cause insurance premiums to increase 1%, she said.


Our stories may be republished online or in print under Creative Commons license CC BY-NC-ND 4.0. We ask that you edit only for style or to shorten, provide proper attribution and link to our web site. Please see our republishing guidelines for use of photos and graphics.

Faith Miller
Faith Miller

Reporter Faith Miller covers the Colorado Legislature, immigration and other stories for Colorado Newsline.