How policymakers innovate around behavioral health: adoption of the New Mexico "No Behavioral Health Cost-Sharing" law

Samantha J Harris; Ezra Golberstein; Johanna Catherine Maclean; Bradley D Stein; Susan L Ettner; Brendan Saloner

doi:10.1093/haschl/qxad081

How policymakers innovate around behavioral health: adoption of the New Mexico "No Behavioral Health Cost-Sharing" law

Health Aff Sch. 2023 Dec 6;2(1):qxad081. doi: 10.1093/haschl/qxad081. eCollection 2024 Jan.

Authors

Samantha J Harris¹, Ezra Golberstein², Johanna Catherine Maclean³, Bradley D Stein⁴, Susan L Ettner^{5

6}, Brendan Saloner¹

Affiliations

¹ Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, United States.
² Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, United States.
³ George Mason University Schar School of Policy and Government, Arlington, VA 22201, United States.
⁴ RAND Corporation, Pittsburgh, PA 15213, United States.
⁵ Department of Medicine, Division of General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, CA 90095, United States.
⁶ Department of Health Policy and Management, University of California Los Angeles, Los Angeles, CA 90095, United States.

Abstract

State policymakers have long sought to improve access to mental health and substance use disorder (MH/SUD) treatment through insurance market reforms. Examining decisions made by innovative policymakers ("policy entrepreneurs") can inform the potential scope and limits of legislative reform. Beginning in 2022, New Mexico became the first state to eliminate cost-sharing for MH/SUD treatment in private insurance plans subject to state regulation. Based on key informant interviews (n = 30), this study recounts the law's passage and intended impact. Key facilitators to the law's passage included receptive leadership, legislative champions with medical and insurance backgrounds, the use of local research evidence, advocate testimony, support from health industry figures, the severity of MH/SUD, and increased attention to MH/SUD during the COVID-19 pandemic. Findings have important implications for states considering similar laws to improve access to MH/SUD treatment.

Keywords: MHPAEA; Medicaid Maintenance of Eligibility Public Health Emergency expiration; Multiple Streams Framework; access to mental health and substance use treatment; behavioral health cost-sharing; private insurance; public policy analysis.