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.

This document, submitted by the Washington Metropolitan Auto Body Association (WMABA), outlines the consumer-driven necessity for HB 808. The legislation aims to address systemic transparency issues within the insurance claims process to protect Virginia residents from unfair settlement practices. Executive Overview: HB 808 is presented as a essential consumer protection measure designed to end "shadow adjusting"—the practice of insurers arbitrarily reducing claim payouts behind closed doors. The bill focuses on three primary pillars: 1. Eliminating Arbitrary Payout Cuts: Prevents "desk adjusters" or AI systems from slashing field estimates by 20% to 50% without ever physically inspecting the damage. 2. Mandating Transparency: Requires adjusters to retain all versions of a loss estimate and provide detailed, written justifications for any modifications made to the original report. 3. Reducing Financial Strain: Aims to lower litigation costs and repair delays by forcing insurers to "show their work," allowing disputes to be settled through clear communication rather than expensive lawsuits. The Consumer Impact: The document highlights that current industry practices often force Virginians to pay out-of-pocket for safety-critical repairs or accept low-quality work that fails to meet carmaker standards. By mandating an honest "paper trail," HB 808 ensures that payouts are based on safety and facts rather than hidden bottom-line tactics. Thank you for your consideration.

Dear Chair Maldonado and Members of the Subcommittee, On behalf of the Association for Clinical Oncology, I am pleased to submit a letter in support of HB 1271, which would protect Virginians with cancer from harmful PBM practices. Please let me know if you have any questions about cancer care - we're happy to be a resource.

This is common sense legislation that I urge the committee to approve. If we can get estimates for repair work on our cars and houses, why not on our bodies? It's time for Virginia to end the stress of surprise billing and empower patients to make informed decisions about their health.

I am writing to express my support for HB1276, a bill before before your subcommittee on Tuesday, February 9 that would give Virginians basic, common-sense information about what they may be asked to pay for non-emergency medical care. Too often, patients agree to routine tests or procedures without any idea of the cost, only to receive bills they never would have consented to had they known the amount in advance. HB1276 addresses this gap by asking providers to tell patients they have a right to a reasonable, good-faith effort to tell patients what they are likely to owe, including when an unmet deductible will significantly increase their responsibility. This bill is about informed consent, fairness, and affordability — values that matter deeply to our base. It also includes protections for providers who act reasonably and rely on information from insurers or patients. HB1276 is a modest step, but it would make a real difference for people trying to navigate health care decisions responsibly and avoid unexpected financial harm. I hope you will give HB1276 your full support. Thank you for your time and service.

Subject: Please Support HB1276 — Basic Cost Transparency for Patients Dear delegates: I am writing to express my support for HB1276, a bill before before your subcommittee on Tuesday, February 9 that would give Virginians basic, common-sense information about what they may be asked to pay for non-emergency medical care. Too often, patients agree to routine tests or procedures without any idea of the cost, only to receive bills they never would have consented to had they known the amount in advance. HB1276 addresses this gap by asking providers to tell patients they have a right to a reasonable, good-faith effort to tell patients what they are likely to owe, including when an unmet deductible will significantly increase their responsibility. This bill is about informed consent, fairness, and affordability — values that matter deeply to our base. It also includes protections for providers who act reasonably and rely on information from insurers or patients. HB1276 is a modest step, but it would make a real difference for people trying to navigate health care decisions responsibly and avoid unexpected financial harm. I hope you will give HB1276 your full support. Thank you for your time and service. Sincerely, Shaheen Khurana 3002 Miller Heights Road Oakton, VA 22124

I am in support of this bill because it is a way to improve our health care system.

The number one reason families go bankrupt in this country is because of medical debt. Having health care providers provide an out-of-pocket cost estimate to individuals and families *before* they receive coverage, allows them to look elsewhere for lower cost care if necessary. Due to an insurance change, I almost had to pay $1,500 for routine MRI. I was fortunate that the person at the front desk let me know the cost before the procedure as a courtesy, allowing me to find a more reasonably priced one elsewhere. Most folks don't find out until they receive a bill in the mail. If Democratic leaders are truly focused on affordability, HB1276 should be passed. Thank you.

I'd like to urge the members of the subcommittee to support this legislation, HB1276, which would give individuals and families in the Commonwealth a chance to understand the costs before they receive non-emergency health care services. For almost every commercial service, Virginians have the reasonable expectation that they receive an estimate before agreeing to move forward. But right now there is no way to ensure families receive an estimate of costs for non-emergency healthcare. Healthcare costs are a leading cause of personal bankruptcies in the Commonwealth and around the country. This legislation would be a smart and easy way to ensure they know what they're getting into before it is too late. Please pass HB1276 and send it to the Senate for approval. Thank you.

The Virginia Mortgage Bankers Association supports passage of HB 1307.

Please see attached PDF.

My name is Katy Schnitger. I am a brain injury survivor and caregiver. In 2007, I was in a catastrophic accident with my young children. My younger child and I both sustained traumatic brain injuries. When our accident happened, we had what most people would call “excellent” health insurance. But what followed were years of denials and appeals. Services our doctors said were medically necessary were labeled “not covered” or “not needed.” I paid out of pocket for cognitive rehabilitation and communication therapy, neuropsychological evaluations, neurofeedback, and neurostimulation therapy. For years. Times two. While trying to heal, I was also trying to survive financially. Brain injury does not heal on a schedule . There is no finish line at six months or one year, or even two. Recovery is slow and unpredictable. HB 1338 matters because it says people with brain injuries should not be abandoned by their insurance when they are most vulnerable. This bill gives families hope instead of hurdles. Please support HB 1338. Thank you.

Madam Chair and members of the committee, I am writing on behalf of Voices for Viriginia’s Children. We support HB1400, which requires health insurance carriers to cover maternal mental health screenings. Research from the American Heart Association demonstrates that such early identification and receiving subsequent treatment results in improved short and long-term health outcomes for both the birthing parent and child. We hope you will support this bill.