submitted by Nora Miller Smith

The LWVMD believes that every Maryland resident should have access to equitable, affordable, quality health care, including behavioral health care. Behavioral health problems directly impact a person’s health, and often, their life. Children and adults with unidentified and untreated behavioral health problems can wind up in Emergency Rooms, Intensive Care Units, jails, or morgues.

During the 2023 session, some of the enacted behavioral health legislation included measures to increase access to behavioral health care in primary care providers’ offices, fund the suicide prevention and behavioral health crisis hotline 9-8-8, increase access and funding for home and community-based services for children and youth, and begin the establishment of Certified Community Behavioral Health Clinics.

But more needs to be done. Per the Department of Legislative Services 2024 Issue Papers: “The mental health needs of adults and children have remained elevated or underserved since the pandemic.” The Youth Risk Behavior Survey for the 2021-2022 school year shows that between 35% and 40% of Maryland middle and high schoolers reported feeling “sad/hopeless,” with over 25% of middle schoolers and 20% of high schoolers disclosing that they have “seriously considered suicide.” The Issue Paper also notes that 27.3% of Maryland adults reported symptoms of anxiety and/or depression, with almost a third of them unable to obtain treatment.

Per the Kaiser Family Foundation, Maryland’s drug overdose rates increased from 11.7 per 100,000 in 2011 to 42.8 per 100,000 in 2021. And the Maryland Hospital Association notes that 1.5 million Emergency Department visits per year are for Maryland residents seeking crisis care for mental health or substance use disorders. If inpatient psychiatric care is needed, adults and children sometimes wait for weeks in those EDs for appropriate placement. And coupled with the increased need for these services is an acute shortage of behavioral health professionals.

The LWVMD supports legislative efforts to expand access to health care for ALL Maryland residents. Some of the healthcare bills filed thus far this year include those that would: mandate coverage for annual behavioral health wellness visits for patients with Medicaid and certain other health insurance policies, improve the integration of Medicaid’s somatic and behavioral health services, and expand the authority of the Prescription Drug Advisory Board to reduce prescription drug costs for ALL Marylanders, not just those on State health plans.

And after last year’s failure to pass the “Access to Care Act,” legislation will be introduced this session that would allow ANY Maryland resident, regardless of immigration status, to purchase health insurance through the Maryland Health Benefit Exchange. Currently federal law forbids undocumented residents from purchasing one of the quality, affordable ACA health plans offered by the Exchange, but a federal waiver would reverse that prohibition. The bill would require the Exchange to apply for that federal waiver, thus opening up the Marketplace to undocumented Marylanders. Six percent of Maryland residents- about 370,000 people- currently do not have health insurance. Passage of the new legislation would reduce that number considerably.

Finally, the League will once again support the “End-of-Life Option Act,” enabling Marylanders with a terminal illness to have more control over their final days. When seen through a patient-centered-care lens-- which should be how all quality health care is designed and delivered-- relief of suffering is a crucial treatment goal. This important legislation would provide patients with an option to end their suffering if they choose to do so.

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