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Depressed Americans are starting to lose access to telehealth therapy. Here's what Congress is doing about it

While Medicaid still covers telehealth appointments as long as the public health emergency is in effect, some private insurance companies have stopped covering it.

WEST DES MOINES, Iowa — Mental health therapist Joby Holcomb experienced a wave of relief as he received his COVID-19 vaccination last Monday. Now, he can finally treat patients for mental health services in person, safely. 

Holcomb, who practices in West Des Moines, says it couldn't come at a better time. Many patients who have relied on telehealth for safely-distanced mental health therapy sessions have started to see their insurance companies stop covering telehealth appointments. Forced with the choice to come in-person and risk their health, or not do therapy at all, many patients are dropping services.

"So some individuals who we’re doing telehealth with now are forced to make a decision about okay, do I come into the office when I’m not feeling comfortable in the middle of a pandemic? Or do I discontinues services?" said Holcomb.

Currently, most insurance providers, and Medicaid, cover telehealth appointments and plan to do so as long as the Public Health Emergency is in effect. Meanwhile, Congressional lawmakers are working to make telehealth more accessible long after COVID-19 is over.

Telehealth has opened up opportunities to do therapy at a distance, but under current law, most patients who move out-of-state are no longer able to see their provider, who is bound by their state license. An out-of-state therapist will likely not covered by their new place of employment's insurance. 

Saying goodbye to a therapist in the midst of an out-of-state move isn't recommended by Holcomb, if it's not necessary.

"Let’s say that we’ve been seeing each other for maybe a couple of years and we’ve established a really good relationship, and all of a sudden that individual has to move because of a job," said Holcomb. "Unless we’re licensed in that other state, we can’t provide that service to them which makes that very difficult."

The Equal Access to Care Act would allow providers to treat patients who move out of state, so they can continue therapy with the same provider during a big life change. However, that policy will expire six months after the public health emergency ends. 

Another bill is the Telehealth Modernization Act, which would remove the state licensing barriers that keep providers from treating the same patient who has moved. This bill, unlike the one above, would be permanent, so years after the pandemic is over, patients can keep with the same therapist.

As for substance abuse treatment, the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act would allow patients who seek substance abuse treatment to continue doing so after the pandemic is over. 

"My hope is that some of this legislation can get passed," Holcomb said. 

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