Biden adviser on pressuring insurers to cover mental health

WILLIAM BRANGHAM: President Biden has been hitting the road to sell his economic record, emphasizing pocketbook and consumer issues, including a new rule this week to crack down on insurers for inadequate coverage of mental health care.

But his agenda also faces some headwinds.

The Federal Reserve's decision to hike interest rates again today is a sign that the battle against inflation is not over.

And, yesterday, a federal judge blocked a key part of the president's immigration policy.

To talk about all of this, we are joined by Neera Tanden.

She is the president's domestic policy adviser.

Neera Tanden, thank you for being back on the "NewsHour."

First to immigration.

Yesterday, this judge ruled that a key part of President Biden's asylum policy was unlawful.

And this came after complaints that you well know that the policy was cruel and was a warmed-over version of the Trump policy.

How much does this ruling constrain your ability to deal with the border?

NEERA TANDEN, White House Domestic Policy Adviser: As you know, in the ruling itself, the judge stayed his own order.

So it's really important for people to understand that the rules the president has put in place are operational.

We have seen a large-scale decline in border crossings since the implementation of this rule.

The rule is working effectively to get better control of the border.

And that is part of the argument that we are making.

We -- as I understand it, the Department of Justice has issued statements saying how confident they are in the process, how confident they are that we will win on appeal.

And what's really most important for people to remember is that this rule has really helped stabilize the border and it is a central part of ensuring that we have stable immigration policies.

WILLIAM BRANGHAM: All right, turning to some of these pocketbook issues, yesterday, the administration rolled out a proposal to pressure health insurance companies to do a better job of covering mental health care.

What is the evidence, as you see it, that they are not living up to that right now?

NEERA TANDEN: Well, according to various studies, people who have insurance are paying out of pocket.

In fact, it is more than twice as likely -- if you have insurance, you're more than twice as likely to pay out of pocket than -- for mental health care than for physical health care.

And we know that Americans who are insured are paying billions of dollars a year for mental health care.

That is not supposed to be.

Over 15 years ago, the Congress passed, on a bipartisan basis, the Mental Health Parity Act.

The Mental Health Parity Act stipulated and really demanded that mental health care is treated like physical health care by the health care system.

But what we have seen over the last several years is that there are tactics and perhaps even evasions of the system.

Insurance companies have mental health providers in their network, but there are just too few of them.

So people have to wait years to get access to therapy that is covered.

Or there are prior authorizations, hurdles that people have to go to, to access mental health care.

And, sometimes, the reimbursement level is different for mental health care for doctors.

For psychiatrists, reimbursement level is lower for them than for physicians or doctors who are helping with physical care.

All of that contributes to a system where it's just much harder to get covered care from -- mental health care than physical care.

And that is why the president acted.

WILLIAM BRANGHAM: One of the things -- and you touched on this -- and health insurers make this argument, and, certainly, there is evidence that this is the case as well.

I have seen this in my own reporting, that, even if you do have coverage, that finding a provider to care for you is very, very difficult.

Isn't that an equally problematic part of this issue?

NEERA TANDEN: Well, all of these issues interact.

And let me explain how.

If you are a psychiatrist, and you get a lower level of reimbursement from the insurers than physicians, sometimes, you're going to think that it's just more difficult to take -- to be in an insurance system, and maybe you will just go the route of only having people pay out of pocket.

But that -- you know, the people -- the number of people who can really pay out of pocket or very few.

What we find is that, when reimbursement levels are the same, when insurance systems are trying to ensure that they have enough providers, that that actually creates an incentive structure for more people to be providing this kind of care.

So it is absolutely the case that we need more mental health providers.

But we also need insurance systems to partner and support in solving this problem by ensuring that they're providing enough mental health therapists, physicians who can provide mental health care, mental health providers in their networks, so people can access care.

WILLIAM BRANGHAM: Turning to the broader economy, as you know, the Fed raised interest rates again, which makes borrowing money, costlier.

One in three Americans right now believe that President Biden is not doing enough to address their economic concerns.

What is the administration doing about that?

NEERA TANDEN: The president has been laser-focused on ensuring that we are doing everything we can to lower costs.

I work on health care policy for the president.

We have a robust agenda of lowering prescription drug costs.

Medicare will be negotiating drug prices for the first time.

That will lower drug costs.

We should also recognize that inflation has adjusted.

In fact, inflation has decreased every month for the last year.

That doesn't mean our work is done.

There's plenty more work to do.

But we should recognize that this economy has created 13 million more jobs, inflation is declining, and we have also created an economy where we have amongst the lowest unemployment rates in recent history.

So there's work to do on lowering costs.

But we also recognize that this is a strong and stable economy that's really growing from the middle out and the bottom up.

WILLIAM BRANGHAM: All right, Neera Tanden, domestic policy adviser to President Biden, thank you so much for being here.