OPINION: Colorado must be a trailblazer on youth mental health services and solve the commercial insurance problem

Unfortunately, in Colorado, there is an increasing need for youth mental health services and a rising percentage of young people are not receiving the help they need.

A 2023 study by the Colorado Health Institute found that 22.3% of Coloradans aged 5 to 25 reported poor mental health and 18.6% of young people said they needed mental health care but didn't get it in the past year — both of those metrics have increased threefold over the past decade, the study found.

We are in the midst of a youth mental health crisis and a new report also conducted by the nonprofit Colorado Health Institute shows that commercial health insurance coverage is not up to the task.

The report found that employer insurance plans do not cover comprehensive youth mental health services — and doing so would be cost-prohibitive for employers. Current efforts to fix commercial insurance aren't taking into account the expense that inherently gets passed on to employers or buyers of insurance on the exchange. The report further concluded that a program allowing employers and families to buy in on existing and robust Medicaid coverage for kids could result in better and more affordable access to youth mental health care.

As the president of Speak Our Minds, the nonprofit organization that commissioned the latest report, I am keenly focused on creating an effective system of care to address the youth mental health crisis.

We need solutions now and one is within reach that won't create overly costly burdens for our business community or families, or let commercial insurance off the hook. Allowing employers and families to access Medicaid coverage would get our youth the services they need while keeping insurance plans financially viable.

A Medicaid buy-in would allow private insurance customers and others who are not eligible for traditional Medicaid to purchase a full spectrum of behavioral health services for children and youth from their state's Medicaid program, rather than getting that coverage through their private health insurer. Private insurance would continue to cover all other services but would pay the buy-in costs to fulfill their obligations to meet coverage and network adequacy requirements.

So why have Medicaid plans gotten it right when commercial insurance plans fall so short? Follow the money.

Importantly, the regulatory structure and financial incentives of private insurance mean that benefits critical to addressing the youth mental health crisis — including prevention, screening and early diagnosis — are not often covered. Private insurance tends to focus on higher acuity care, the type of care for which specialists and doctors can bill. Early detection and intervention are critical components of delivering impactful youth mental health care but adding these services to employer health insurance plans are likely to cause costs to skyrocket and become untenable for businesses.

Meanwhile, Medicaid's behavioral health services for children and adolescents are part of the program's overall benefit package, known as Early and Periodic Screening, Diagnostic and Treatment. It includes a robust set of benefits and aims to ensure children receive early detection and care to treat health problems through regular health and developmental screenings. In theory, Medicaid offers a richer set of behavioral health benefits.

In a 2023 national survey by the nonprofit Business Group on Health, 77% of employers reported increased mental health issues such as depression, anxiety and substance use disorder among their workers and their dependents. Businesses offer health insurance as a perk and they want to ensure their employees can access the services they and their families need. A Medicaid buy-in option for youth mental health services could mean significant cost savings for employer plans.

The concept of a Medicaid buy-in for youth mental health services is garnering support in the Colorado state assembly. Sen. Dafna Michaelson Jenet, a Democrat from Commerce City, is motivated to take action that could include legislation this session.

As we continue to search for ways to ensure our kids and teens have the mental health care they need and deserve, I call on all Coloradans to reach out to their representatives and ask them to explore the possibility of a Medicaid buy-in for youth mental health services.

Every day we waste is another day our youth pay the price for our failures.

Heidi Baskfield, of Denver, is the executive director of Speak Our Minds, a Colorado-based nonprofit organization focused on creating a comprehensive system for youth mental health care. This columns was originally published by The Colorado Sun.