The 21st Century Cures Act, the first major mental health legislation in nearly a decade, was passed by the Senate on Dec. 7. The House of Representatives approved the measure on Dec. 1, sending it to the desk of President Barack Obama, who has promised to sign it.
“This legislation will improve the lives and health of countless Americans. It will increase access to effective, evidence-based care, particularly for those with serious mental illness,” said American Psychological Association (APA) President Susan H. McDaniel, Ph.D., in an APA press release.
In addition to strengthening the Mental Health Parity and Addiction Equity Act, which restricts insurers from imposing limitations on mental health and substance use treatment, the new features new provisions. According to the APA, these include:
“By passing HR 34, the House and Senate have shown that they consider fixing our nation’s broken mental health system to be a national priority,” said National Association on Mental Illness (NAMI) Chief Executive Officer Mary Giliberti in a statement. “We are grateful to senators Chris Murphy (D-CT), Bill Cassidy (R-LA) and John Cornyn (R-TX), Lamar Alexander (R-TN) and Patty Murray (D-WA) for their leadership. Congress has clearly heard the hundreds of thousands of messages from NAMI advocates and members of the mental health community who never faltered in their call for improving programs and removing federal barriers to mental health care.”
In a White House statement, Obama said “the bipartisan passage of the 21st Century Cures Act is an example of the progress we can make when people from both parties work together to improve the health of our families, friends and neighbors.”
The bill has not drawn universal acclaim, however.
Critics of the bill cite drug cost, approval concerns
Nothing in the bill covers drug costs. “At a time when Americans pay, by far, the highest prices in the world for prescription drugs, this bill provides absolutely no relief for soaring drug prices,” said Sen. Bernie Sanders, (I-VT). “When American voters say Congress is owned by big companies, this bill is exactly what they are talking about,” said Senator Elizabeth Warren (D-MA) in a speech last week.
Additionally, some health care professionals are concerned the bill weakens the authority of the Food and Drug Administration (FDA). The bill allows drug manufacturers to use observational studies or safety monitoring to support the approval of new drugs – previously, only clinical trials were allowed by the FDA. “This continues a trend of eroding standards at the Food and Drug Administration since the 1990s,” said Michael Carone, director of the consumer advocacy group Public Citizen’s Health Research Group in a statement issued last month.
Finally, according to an analysis by Kaiser Health News, the bill also cuts $3.5 billion from the Affordable Care Act’s Prevention and Public Health Fund. Among other things, this fund fights hospital infections and Alzheimer’s disease.
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