[Congressional Record Volume 164, Number 102 (Tuesday, June 19, 2018)]
[House]
[Pages H5231-H5233]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                     CHIP MENTAL HEALTH PARITY ACT

  Mr. WALDEN. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 3192) to amend title XXI of the Social Security Act to 
ensure access to mental health services for children

[[Page H5232]]

under the Children's Health Insurance Program, and for other purposes, 
as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 3192

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``CHIP Mental Health Parity 
     Act''.

     SEC. 2. ENSURING ACCESS TO MENTAL HEALTH AND SUBSTANCE USE 
                   DISORDER SERVICES FOR CHILDREN AND PREGNANT 
                   WOMEN UNDER THE CHILDREN'S HEALTH INSURANCE 
                   PROGRAM.

       (a) In General.--Section 2103(c)(1) of the Social Security 
     Act (42 U.S.C. 1397cc(c)(1)) is amended by adding at the end 
     the following new subparagraph:
       ``(E) Mental health and substance use disorder services (as 
     defined in paragraph (5)).''.
       (b) Mental Health and Substance Use Disorder Services.--
       (1) In general.--Section 2103(c) of the Social Security Act 
     (42 U.S.C. 1397cc(c)) is amended--
       (A) by redesignating paragraphs (5), (6), (7), and (8) as 
     paragraphs (6), (7), (8), and (9), respectively; and
       (B) by inserting after paragraph (4) the following new 
     paragraph:
       ``(5) Mental health and substance use disorder services.--
     Regardless of the type of coverage elected by a State under 
     subsection (a), child health assistance provided under such 
     coverage for targeted low-income children and, in the case 
     that the State elects to provide pregnancy-related assistance 
     under such coverage pursuant to section 2112, such pregnancy-
     related assistance for targeted low-income women (as defined 
     in section 2112(d)) shall--
       ``(A) include coverage of mental health services (including 
     behavioral health treatment) necessary to prevent, diagnose, 
     and treat a broad range of mental health symptoms and 
     disorders, including substance use disorders; and
       ``(B) be delivered in a culturally and linguistically 
     appropriate manner.''.
       (2) Conforming amendments.--
       (A) Section 2103(a) of the Social Security Act (42 U.S.C. 
     1397cc(a)) is amended, in the matter before paragraph (1), by 
     striking ``paragraphs (5), (6), and (7)'' and inserting 
     ``paragraphs (5), (6), (7), and (8)''.
       (B) Section 2110(a) of the Social Security Act (42 U.S.C. 
     1397jj(a)) is amended--
       (i) in paragraph (18), by striking ``substance abuse'' each 
     place it appears and inserting ``substance use''; and
       (ii) in paragraph (19), by striking ``substance abuse'' and 
     inserting ``substance use''.
       (C) Section 2110(b)(5)(A)(i) of the Social Security Act (42 
     U.S.C. 1397jj(b)(5)(A)(i)) is amended by striking 
     ``subsection (c)(5)'' and inserting ``subsection (c)(6)''.
       (c) Assuring Access to Care.--Section 2102(a)(7)(B) of the 
     Social Security Act (42 U.S.C. 1397bb(c)(2)) is amended by 
     striking ``section 2103(c)(5)'' and inserting ``paragraphs 
     (5) and (6) of section 2103(c)''.
       (d) Mental Health Services Parity.--Subparagraph (A) of 
     paragraph (7) of section 2103(c) of the Social Security Act 
     (42 U.S.C. 1397cc(c)) (as redesignated by subsection (b)(1)) 
     is amended to read as follows:
       ``(A) In general.--A State child health plan shall ensure 
     that the financial requirements and treatment limitations 
     applicable to mental health and substance use disorder 
     services (as described in paragraph (5)) provided under such 
     plan comply with the requirements of section 2726(a) of the 
     Public Health Service Act in the same manner as such 
     requirements or limitations apply to a group health plan 
     under such section.''.
       (e) Effective Date.--
       (1) In general.--Subject to paragraph (2), the amendments 
     made by this section shall take effect with respect to child 
     health assistance provided on or after the date that is one 
     year after the date of the enactment of this Act.
       (2) Exception for state legislation.--In the case of a 
     State child health plan under title XXI of the Social 
     Security Act (or a waiver of such plan), which the Secretary 
     of Health and Human Services determines requires State 
     legislation in order for the respective plan (or waiver) to 
     meet any requirement imposed by the amendments made by this 
     section, the respective plan (or waiver) shall not be 
     regarded as failing to comply with the requirements of such 
     title solely on the basis of its failure to meet such an 
     additional requirement before the first day of the first 
     calendar quarter beginning after the close of the first 
     regular session of the State legislature that begins after 
     the date of enactment of this section. For purposes of the 
     previous sentence, in the case of a State that has a 2-year 
     legislative session, each year of the session shall be 
     considered to be a separate regular session of the State 
     legislature.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Oregon (Mr. Walden) and the gentleman from Massachusetts (Mr. Kennedy) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Oregon.


                             General Leave

  Mr. WALDEN. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous materials in the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Oregon?
  There was no objection.
  Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, last week the House advanced dozens of bills to help 
save lives and stem the tide of the opioid crisis that has struck at 
the health of our people wherever they live. We are back here again 
this week to consider additional legislation that can help our 
communities fight back against this epidemic.
  We have all read the headlines about this tragedy, and we have heard 
the stories firsthand across our respective districts. We are 
confronting an addiction that mercilessly seizes control and then 
destroys. This killer does not discriminate--not by age, not by race, 
not by where you live or by what you believe.
  Opioid addiction continues to take the lives of more than 100 
Americans every single day. But it is what is behind the numbers that 
really matters. These are real people. Their stories are real. They 
tragically have lost their bright futures and left loved ones sadly 
behind. So we have come together to advance legislation that will help 
put a stop to this unprecedented crisis that has left a mark on just 
about every family across America.
  Mr. Speaker, I urge my colleagues to support the legislation before 
the House today--we have various bills--and throughout the course of 
this week. We have an opportunity to save lives, and we have a 
responsibility to our families, our friends, our communities, and our 
Nation to lift people out of addiction and get America on a better 
path.
  The first bill up this afternoon, Mr. Speaker, is sponsored by our 
colleague from Massachusetts, Representative Kennedy. It requires the 
Children's Health Insurance Programs to cover comprehensive mental 
health and substance use disorder services for pregnant women and 
children.
  State CHIP programs may be offered by expanding Medicaid, separate 
programs that stand alone from Medicaid, or CHIP may be offered through 
a combination of both approaches. Each of these types of Children's 
Health Insurance Programs covers some mental health services, but not 
all cover substance use disorder services. So there is a gap.
  This bill requires the Children's Health Insurance Programs, 
regardless of type, to cover mental health services, including 
substance use disorder services. The bill requires States with separate 
CHIP programs to monitor access to mental health and substance use 
disorder services.
  Finally, the bill requires States with separate CHIP programs to 
ensure that mental health parity with group health plans is met.
  Most CHIP programs already meet the standards in the bill. This is 
simply a codification of current practices and does so without 
additional costs. So it is important.
  Mr. Speaker, I am grateful to be able to bring this bill to the 
floor, and I congratulate my colleague from Massachusetts who brought 
this issue to our attention.
  Mr. Speaker, I reserve the balance of my time.
  Mr. KENNEDY. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of H.R. 3192. I want to begin by 
thanking the chairman of our committee, Mr. Walden, for giving us a 
hearing on this bill and for moving the process forward. I thank the 
gentleman along with Dr. Burgess; Ranking Member Pallone; Ranking 
Member Green; and our cosponsor, Democratic colead Mrs. Napolitano as 
well.
  Mr. Speaker, a couple of decades ago, my uncle, Senator Edward 
Kennedy, and Senator Orrin Hatch created the CHIP program because of a 
consensus that children should never be caught in the midst of our 
debates over healthcare. It has been a successful, bipartisan program 
that has saved lived lives and has helped families facing their deepest 
despair. But just like any program, Mr. Speaker, it has been a work in 
progress.
  This bill offers a simple fix to a troubling problem. According to 
some estimates, nearly 500,000 children and pregnant mothers covered by 
CHIP are not

[[Page H5233]]

guaranteed mental health care or substance use disorder treatment. We 
have guaranteed that treatment for Americans covered by Medicaid, 
private insurance, and employer-sponsored insurance. It is time we do 
so for low-income families and babies as well.
  In our efforts to confront an opioid epidemic that cares for no age, 
no income, no race--nothing at all--this bill is a crucial piece of our 
response.
  With that, Mr. Speaker, I would like to thank everyone at the 
Legislative Counsel's Office, at CMS, and the staff on both sides of 
the aisle from the Energy and Commerce Committee, and, in particular, 
Rachel Pryor, for putting up with my relentless and sometimes misguided 
questions.
  Mr. Speaker, I yield back the balance of my time.
  Mr. WALDEN. Mr. Speaker, I have no other speakers on this matter. I 
know the gentleman has yielded back. I will do the same after calling 
on our colleagues to support this important and meaningful legislation.
  Mr. Speaker, I yield back the balance of my time.
  Ms. JACKSON LEE. Mr. Speaker, I rise in strong support of H.R. 3192, 
the ``CHIP Mental Health Parity Act.''
  H.R. 3192 would ensure access to mental health and substance use 
disorder prevention and treatment services for children under the 
Children's Health Insurance Program (CHIP).
  Beginning in infancy and continuing through adolescence, children 
need access to mental health screening and assessment and a complete 
array of evidence-based therapeutic services.
  Around 1 in 5 children in the U.S. suffers from a diagnosable mental 
disorder, but only 20 to 25 percent of affected children will receive 
treatment.
  Untreated mental health and substance use disorders are associated 
with family dysfunction, school expulsion, poor school performance, 
juvenile incarceration, unemployment, and suicide.
  CHIP has been an essential source of children's health coverage, 
ensuring that families have access to high quality, affordable, 
pediatric health care for children in working families whose parents 
earn too much to qualify for Medicaid but too little to purchase 
private health insurance on their own.
  Given the prevalence of mental health and substance use disorders in 
children and the nationwide opioid epidemic, it is essential now more 
than ever that all children and adolescents enrolled in CHIP have 
access to mental health and substance use disorder screening and 
treatment.
  There are currently over 400,000 CHIP recipients in Texas.
  This figure is significantly less than in 2014, when nearly half of 
all children in Texas were enrolled in CHIP or Medicaid.
  Mr. Speaker, I strongly support H.R. 3192 and the estimated 8.9 
million children across the United States who rely on CHIP for their 
necessary health services.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Oregon (Mr. Walden) that the House suspend the rules and 
pass the bill, H.R. 3192, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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