Access to mental health care is one of the most urgent public health challenges facing our communities. Rates of anxiety, depression, trauma-related disorders, and neurodevelopmental conditions continue to rise, yet access to timely and affordable treatment remains limited. One of the most significant barriers to care is inadequate reimbursement by private insurance companies.
I submit this testimony as a licensed clinical psychologist in private practice serving this community. Private practices provide much of outpatient mental health care, particularly for individuals and families needing ongoing treatment. Insurance reimbursement policies directly affect whether clinicians can remain in-network, keep practices open, and continue serving the community. Improving access must also include protecting the mental health workforce.
Although mental health parity laws exist, parity has not translated into real access. Fewer than half of individuals with a diagnosable mental health condition receive treatment in a given year, with cost and insurance-related barriers cited as leading reasons for unmet needs (SAMHSA, 2023; Wang et al., 2005).
A primary driver of this access gap is low reimbursement. Research shows reimbursement rates for behavioral health care are substantially lower than for comparable medical services (Bishop et al., 2014). In many cases, private insurance reimbursement for psychotherapy approaches or falls below Medicare rates, while imposing added administrative burden through authorizations, documentation, and claims denials.
Low reimbursement limits provider participation in insurance networks. Many psychologists, therapists, and psychiatrists reduce or discontinue insurance participation because reimbursement does not cover basic operating costs or support sustainable practice (APA, 2023). This results in narrow networks, long waitlists, and increased reliance on out-of-network care.
These conditions disproportionately affect middle and low-income families, children, and individuals requiring consistent treatment. Even insured patients often cannot find in-network providers accepting new patients. Cost remains one of the strongest predictors of untreated mental health conditions, even among insured individuals (Wang et al., 2005).
Requiring private insurers to reimburse mental health services at no less than Medicare rates is a practical, evidence-based solution. Medicare provides a transparent benchmark that supports basic practice sustainability. Aligning private reimbursement with this floor would likely increase provider participation, stabilize practices, and expand access for insured individuals.
This policy is not about increasing provider profit. It is about preserving a mental health workforce capable of meeting community needs. Protecting clinicians is inseparable from protecting patients. When practices are sustainable, communities benefit through improved access and reduced downstream costs (Insel, 2008).
Having insurance should mean having access to care. Requiring private insurers to reimburse mental health services at least at Medicare rates is a meaningful step toward parity in practice and stronger community mental health.
Access to mental health care is one of the most urgent public health challenges facing our communities. Rates of anxiety, depression, trauma-related disorders, and neurodevelopmental conditions continue to rise, yet access to timely and affordable treatment remains limited. One of the most significant barriers to care is inadequate reimbursement by private insurance companies. I submit this testimony as a licensed clinical psychologist in private practice serving this community. Private practices provide much of outpatient mental health care, particularly for individuals and families needing ongoing treatment. Insurance reimbursement policies directly affect whether clinicians can remain in-network, keep practices open, and continue serving the community. Improving access must also include protecting the mental health workforce. Although mental health parity laws exist, parity has not translated into real access. Fewer than half of individuals with a diagnosable mental health condition receive treatment in a given year, with cost and insurance-related barriers cited as leading reasons for unmet needs (SAMHSA, 2023; Wang et al., 2005). A primary driver of this access gap is low reimbursement. Research shows reimbursement rates for behavioral health care are substantially lower than for comparable medical services (Bishop et al., 2014). In many cases, private insurance reimbursement for psychotherapy approaches or falls below Medicare rates, while imposing added administrative burden through authorizations, documentation, and claims denials. Low reimbursement limits provider participation in insurance networks. Many psychologists, therapists, and psychiatrists reduce or discontinue insurance participation because reimbursement does not cover basic operating costs or support sustainable practice (APA, 2023). This results in narrow networks, long waitlists, and increased reliance on out-of-network care. These conditions disproportionately affect middle and low-income families, children, and individuals requiring consistent treatment. Even insured patients often cannot find in-network providers accepting new patients. Cost remains one of the strongest predictors of untreated mental health conditions, even among insured individuals (Wang et al., 2005). Requiring private insurers to reimburse mental health services at no less than Medicare rates is a practical, evidence-based solution. Medicare provides a transparent benchmark that supports basic practice sustainability. Aligning private reimbursement with this floor would likely increase provider participation, stabilize practices, and expand access for insured individuals. This policy is not about increasing provider profit. It is about preserving a mental health workforce capable of meeting community needs. Protecting clinicians is inseparable from protecting patients. When practices are sustainable, communities benefit through improved access and reduced downstream costs (Insel, 2008). Having insurance should mean having access to care. Requiring private insurers to reimburse mental health services at least at Medicare rates is a meaningful step toward parity in practice and stronger community mental health.