The Honorable Kathy Hochul
Governor of New York State
NYS State Capitol Building
Albany, NY 12224

Dear Governor Hochul:

Unmet demand for timely care made available through a robust continuum of mental health and substance use disorder services that is available to ALL of New York’s children, youth, and families has never been greater. Disparate coverage requirements on commercial insurers have contributed to persistent waiting lists for outpatient and home-based care that range from several weeks to many months with some children and youth forced to live in hospital emergency rooms while awaiting a referral to the appropriate level of follow-up care upon discharge from the hospital.

The Facts

• In NYS in 2023, 11.7% of youth with private insurance had insurance that did not cover mental or emotional problems, ranking it 41st among other states (https://mhanational.org/sites/default/files/2023-State-of-Mental-Health-in-America-Report.pdf)
• In NYS in 2023, 53% of youth with major depression did not receive mental health services in the past year (https://mhanational.org/sites/default/files/2023-State-of-Mental-Health-in-America-Report.pdf)
• In NYS in 2023, 11% of youth are experiencing severe major depression and 16% of youth had at least one major depressive episode in the last year (https://mhanational.org/sites/default/files/2023-State-of-Mental-Health-in-America-Report.pdf)

Last year, Governor Hochul and the NYS Legislature made history by enacting a new law that ensures in-network, community-based mental health and substance use disorder provider agencies, licensed by OMH and/or OASAS, are reimbursed by commercial insurers at rates comparable to those paid by the NYS Medicaid Program for the same services. While the new law opens the front door to care for thousands of New Yorkers with commercial insurance who have struggled to find a community provider that can afford to provide it, the new law does not also address mental health and substance use disorder coverage disparities that currently exist between Medicaid and commercial insurance benefits packages. For example, two important services currently available to children, youth and families with Medicaid coverage - Children and Families Treatment Support Services (CFTSS) and Home and Community Based Services (HCBS) services – are not readily available to families with commercial insurance. HCBS and CFTSS offer a flexible array of services such as therapy, rehabilitation services, and family and youth peer support within a child's home and community.
The undersigned organizations stand with Governor Hochul as she continues to advance policy reforms to invest in the emotional wellbeing of New York’s children and youth. Today, we call upon the Governor to take another historic step on behalf of New York’s children and families by addressing the coverage disparity described above by including budget language in her 2025-2026 budget proposal that would require commercial insurers to make the same broad range of services currently available to children, youth, and families with Medicaid insurance, available to New Yorkers with commercial coverage.

All New Yorkers deserve equal access to the range of mental health and substance use disorder services NYS has identified as essential for our children, youth, and their families with Medicaid insurance. We respectfully request the language (directly below) be included in the January 2025 executive budget.

Proposal to Require State Regulated Commercial Insurance and Child Health Plus to Provide Coverage for Children's Mental Health and SUD Services Consistent with Coverage under the NY Medicaid Program for Children

Amend Section 2511 of Public Health Law (Child Health Plus) and Sections 3216, 3221, and 4303 of Insurance Law (State-Regulated Commercial Insurance) as follows:

Every policy under this section shall include coverage for children's inpatient and ambulatory mental health and substance use disorder services at the same level and consistent with the inpatient and ambulatory mental health and substance use disorder services covered under the state medical assistance program under title 11 of article five of social services law, including such services authorized by state plan amendments, for children aged twenty-one and under.

This shall take effect on January 1, 2026.

Respectfully submitted,

Question Title

* 1. Name of Agency Contact

Question Title

* 2. Email Address of Contact

Question Title

* 3. Agency/Organization Name as it should appear on the sign on letter

Question Title

* 4. Would you like to be contacted about future advocacy efforts on this issue?

T