Murphys in House and Senate Team to Revive Mental Health Overhaul

By:  Melissa Attias
CQ Roll Call

While Pennsylvania Republican Tim Murphy steers a House effort to overhaul the mental health system, his namesake across the Capitol – Connecticut Democrat Christopher S. Murphy – is working to bring Senate Democrats and Republicans together on the issue and strike a compromise.

In an interview in his Senate office, Murphy said he is working on legislation with Louisiana Republican Bill Cassidy that he expects to be “substantially similar” to a bipartisan House measure from the last Congress that is expected to be revived. A group of House Democrats introduced a competing mental health bill last year, and Murphy said that dynamic was one reason he reached out to the House Republican.

As a progressive Democrat and former member of the House, Murphy said he has good relationships with many of the supporters of the Democratic bill led by then-Rep. Ron Barber of Arizona and wants to team up with the Republicans to address concerns that were raised last Congress.

“My hope is that we can get to a product that doesn’t prompt there to be a competing Democratic proposal in the House,” Murphy said, noting that he isn't speaking for his House colleague. “My hope is that we come up with a product that can be unifying.”

In a separate interview, Tim Murphy said he and the senator had a long meeting about the principles in the bill and that he’s trying to talk to Democrats to build support before he releases the House language, likely in the coming weeks. He added that the bill is in the Energy and Commerce Committee's “queue of things to do.”

A former state legislator, Christopher S. Murphy said he entered the House in 2007 with a goal of overhauling the broader health care system and spent a lot of time helping to draft the health care law (PL 111-148, PL 111-152) during his second term as a member of the Energy and Commerce Committee.

Although the law included provisions for behavioral health care, Murphy thinks Democrats recognize that they didn’t do enough to address the inadequacies in the current system. And he believes there is space in Congress to have a discussion about health policy changes, despite lingering controversies over the law.

“I think we should be proud of what has happened as we’ve closed down institutions for people with serious mental illness, but clearly the pendulum has swung too far in the other direction,” he said. “We took people with serious mental illness out of our mental institutions and then reinstitutionalized them in prisons. Others were just left to die on the streets.”

His goal as he works on legislation is “restoring the promise that we made to individuals with serious mental illness when we made the right decision to close down our system of institutional care.” Murphy said the senators are looking at payment changes to open up new inpatient beds, as well as changes to privacy laws to increase the involvement of caregivers for those with serious mental illness.

A focus of the measure, that “wasn’t as much in” the House bill, will be ensuring that behavioral and primary health care are more integrated as the payment system moves from volume-based to quality-based care, he said. He also noted that he would like to change some things in the previous House measure, but that Tim Murphy is also making adjustments that will likely address some of those concerns.

Outpatient Treatment Flap
One point of contention could be a provision in the House bill from the 113th Congress that required a state to have an assisted outpatient treatment law — or a law that allows court-ordered treatment for certain people with serious mental illness while living in a community — to receive money through a block grant for community mental health services.

The senator said Connecticut is one of a handful of states that does not have AOT on the books and has been historically resistant to the concept, so he would be resistant to legislation that would require Connecticut to change its laws. He thinks his House counterpart is still committed to the idea, but said they’re working on ways to address some of the concerns.

Murphy added that the goal is for the House and Senate bills to be introduced together, or at least close to the same time.

While Connecticut was rocked by the December 2012 massacre at Sandy Hook Elementary School by an apparently unbalanced young man, Murphy said he doesn’t think mental health needs “to get tied up into the politics of gun laws.” The Senate Health, Education, Labor and Pensions Committee approved broad mental health legislation in the wake of the shooting, but it stalled as part of a Senate gun-control package in April 2013.

Christopher S. Murphy said most people who talk to him about overhauling the behavioral health system are not part of the gun debate, though he thinks Republicans tried to avoid acting on gun laws for a period “by putting the entire problem onto the back of the mental health system.”

When it comes to Sandy Hook, Murphy says the shooter was failed by the behavioral health system but also shouldn’t have had a weapon that could kill the 20 children he shot so easily.

“The families in Sandy Hook have been pretty clear to me,” he said. “They know that it’s going to take them a long time to get the changes to the gun laws that they think are appropriate, but they don’t want Congress’ reluctance to move forward on gun laws to stop us from making progress that will help millions of Americans who are confronted with the idiocy of our current behavioral health system.”

In the 113th Congress, the House mental health bill had 115 co-sponsors, including 38 Democrats, but it stalled after the Energy and Commerce Health Subcommittee held a hearing on the measure in April 2014 and Barber introduced competing legislation in May. It lacked a Senate companion.