ACA, AAMFT, and CAMFT continue to work with and others in Washington to get LPCs and LMFTs included as eligible providers in Medicare. Bills pending before both the House and Senate would do it. And that change would be beneficial for consumers and taxpayers alike.
There are two main reasons Medicare will benefit from the inclusion of counselors and family therapists:
- Adding LPCs and LMFTs will improve access to mental health and substance abuse care for thousands. The nation’s mental health workforce shortage is well-known. In many rural areas, residents now need to drive long distances to find a qualified person to help them with depression, substance abuse, or other mental health issues. Even in urban areas, adding LPCs and LMFTs will improve the linguistic diversity of the mental health work force. That will make it easier for those who need services in Spanish or other languages to obtain them.
- Adding LPCs and LMFTs will keeps taxpayer costs flat. It may initially seem counterintuitive, but adding LPCs and LMFTs as eligible providers in Medicare actually keeps taxpayer costs for Medicare from dramatically rising, even as more recipients will be able to access services. Two reasons: 1, Master’s-level providers are simply cheaper than Psychologists when providing similar services (and as Russ Crane’s great team of researchers keeps finding, the different mental health professions achieve similar outcomes), and 2, treatment for mental health problems is cheaper when it happens before those problems become crises. A 2002 estimate found that adding MFTs as eligible providers would cost less than $3 million per year — or less than half of 1% of Medicare’s mental health spending.
So why aren’t counselors and family therapists in Medicare? It isn’t for lack of effort. We’ve been included several times in legislation successful in one house. We just haven’t yet made it through both houses of Congress in the same year. But the case for including both professions in Medicare is stronger than ever. At present, bills in the House (HR 3032, and also HR 5531, which is a direct response to the opioid epidemic) and Senate (S 1879) would add LPCs and LMFTs as providers in the Medicare system. Hopefully this is the year the Legislature sees how much we have to offer. You can encourage your representatives to support those bills here (for LMFTs) and here (for LPCs).
Ed. note: This post originally published March 15, 2013. Republished with minor updates July 18, 2018.