During this legislative session, we have the opportunity to improve access to mental health care in a way that promotes economic prosperity and helps our families and communities. That’s why we have filed SB 112 and HB 183 to limit barriers to accessing effective treatments for Floridians with serious mental illnesses.
Just like physical ailments, mental ailments have a significant impact on individuals’ health and ability to work, provide for their families, and contribute to their communities.
Unfortunately, a commonly used insurance practice called step therapy causes harmful delays in patients being able to access the treatment prescribed by their physician. Step therapy, or “fail first,” forces patients to try several insurer-approved medications on the Preferred Drug List (PDL) before insurance will cover the medication that is recommended by their doctor, even if it is a medication that has proven effective for that patient previously.
While referred to as a cost-saving practice, Florida’s step therapy program has a significant financial cost to our healthcare system, workforce and economy. According to a recent study by the Regional Economic Consulting Group, step therapy practices for major depressive disorder alone cost Florida $271.5 million annually. The cost consists of losses to workplace productivity, medical expenses, and costs associated with suicide. The study goes a step further and found that step therapy practices for Medicaid beneficiaries with MDD cost the state $52.3 million annually.
Additional research found that step therapy leads to higher long-term medical costs, as deferred treatment raises the chances of a patient requiring costly emergency room or inpatient treatment for a mental health crisis.
Step therapy’s ‘trial-and-error’ design isn’t just hurting vulnerable Floridians, it’s harming our workforce and economy.
We introduced SB 112 and HB 183 to help address this critical issue. This legislation creates exceptions for certain Medicaid beneficiaries to access physician-prescribed treatment without being subjected to time-consuming step therapy protocols. This legislation does not eliminate step therapy practices across the board. Instead, it focuses on a specific part of the population that may suffer life-altering consequences from delayed access to care.
Even on the best days, it can be difficult for people suffering from serious mental illnesses to perform everyday activities, including going to work and caring for their families. That effort is nearly impossible when these individuals cannot access effective treatment.
Ensuring that Floridians with serious mental illnesses can access the care they need is an important step forward as we continue to address the mental health crisis. We encourage our colleagues on both sides of the aisle to support SB 112 and HB 183 to help Floridians in need while saving our state millions annually.
State Sen. Gayle Harrell, R-Stuart, represents all of Martin County and parts of Palm Beach and St. Lucie Counties. State Rep. Karen Gonzalez-Pitman, R-Tampa, represents parts of Hillsborough County.
Author
