The House on Wednesday overwhelmingly passed a long-delayed mental health bill that Republicans have cast as their response to recent mass shootings.
The measure from Rep. Tim Murphy (R-Pa.), which passed 422-2, had been stalled and mired in controversy for years, but lawmakers in recent months dropped or scaled back many of the most contentious, sweeping measures.
{mosads}That process has led to a bill that is much more modest than the original plan but that advocates are still praising as a good first step. Democrats stressed that more funding is still needed.
The bill aims to improve the oversight and effectiveness of federal mental health programs and authorizes a range of grants for treatment.
Mental health reform has been a rare area where both parties are looking to enact legislation, but a parallel effort in the Senate has been stalled over gun politics, and it is unclear whether a bill can be signed into law this year.
“Our mental health system in this country is a failure, and this is one of those times when we’re not gathered for a moment of silence, but a time of action,” Murphy said Wednesday.
“We’re here, finally, to speak up for the last, the lost, the least and the lonely. That is those that suffer from mental illness.”
Advocates have in particular pointed to a lack of providers and beds at treatment hospitals for mental illness.
The vote comes in a week when Republicans are responding to a Democratic push to pass gun control legislation. Republicans say mental health reform is a way to prevent mass shootings by mentally ill people.
Democrats warn against stigmatizing mental illness and argue that gun laws are needed, but say they support mental health reform for its own sake. Both parties were able to put aside gun politics to pass the bill.
The measure would create a new assistant secretary role in the Department of Health and Human Services (HHS) to oversee mental health and substance abuse programs. The role is intended for a doctor, which Murphy touts as a way to improve the oversight of federal mental health programs that he views as currently ineffective.
The bill also authorizes grants for areas such as preventing suicide and early intervention for children with mental illnesses. Funding for the range of grants will depend on the appropriations process, but Murphy noted that he has talked to appropriators and is hopeful that funding can begin in 2018.
Several of the most ambitious changes had to be rolled back in order to smooth the way for the committee vote.
In particular, a provision to allow Medicaid to pay for more care at mental health facilities, which was projected to cost tens of billions of dollars, drew objections from some Republicans. It was scaled back to codify a new regulation covering stays only if they are less than 15 days long.
Changes in the Health Insurance Portability and Accountability Act, meant to allow information about a mentally ill person to be shared with caregivers, were taken out after objections from Democrats and some Republicans. The bill instead directed HHS to issue a regulation to clarify the privacy rules.
Ron Honberg, senior policy adviser for the National Alliance on Mental Illness, said his organization knew that some provisions would have to be scaled back for the sake of compromise.
“There’s still a lot of really good stuff in this bill,” Honberg said, pointing to early identification and prevention efforts in young people, improved coordination of services and simply changing the conversation.
“All of the focus on this bill has helped shape the conversation,” he added. “A lot of the issues being talked about today weren’t being talked about two or three years ago.”
The Senate has a parallel, bipartisan bill from Sens. Chris Murphy (D-Conn.) and Bill Cassidy (R-La.).
The changes to the House bill have made it similar to the Senate bill, which had always been narrower and less controversial.
However, the Senate bill has faced an obstacle in gun politics. Sen. John Cornyn (R-Texas) wants to combine the measure with his mental health bill, which includes provisions that Democrats denounce as making it easier for mentally ill people to get guns.
There has been no resolution yet on that front, and the measure also faces a tight time window on the Senate floor.