New Mexico’s Mixed Results: Eliminating Co-pays for Behavioral Health and Access to Care

In 2019, New Mexico became the first state in the country to eliminate behavioral health co-pays for individuals in certain insurance plans. A recent study conducted by Ezra Golberstein and his team at the University of Minnesota examined the impact of this law, and their findings were mixed.

Golberstein was initially surprised by the No Behavioral Health Cost Sharing Act when he learned about it through a newsletter. He noted that no other state had attempted such an ambitious approach to reducing costs for consumers and improving access to care. The study showed that within the first six months of the law taking effect, out-of-pocket costs decreased. However, there was no significant increase in individuals seeking mental health treatment.

Golberstein explained that since most prescriptions are for generic drugs, which are already affordable, reducing the cost to zero for these medications did not significantly impact medication dispensing patterns. There was actually a slight rise in new prescriptions for more expensive medications. This suggests that while cost may be a barrier for some individuals seeking care, it is not enough to motivate them to seek treatment if they can still afford it without any additional financial burden.

The limitations of the law became apparent when considering its scope. It specifically targets insurance plans obtained through employers, but many large companies choose self-funded insurance options that are not subject to the carveout for “self-funded” insurance plans. As a result, only individuals with insurance through the Affordable Care Act Marketplace or state employees were affected by the law. Golberstein emphasized that New Mexico continues to serve as a testing ground for this type of legislation and his team plans to conduct further research on its impact on mental health access and costs.

The study was made possible by funding from both the W.K. Kellogg Foundation and KUNM listeners who donated money towards this important research initiative.