Marriage counselors and family therapy will soon be covered by the state’s Medicaid program.

Chapter amendments to legislation passed in 2021 have been passed by the state Legislature changing mental health practitioners to mental health counselors and adding marriage and family therapists to the list of providers covered by Medicaid. Additionally, the chapter amendment removes creative art therapists and psychoanalysts from Medicaid coverage. The chapter amendment passed the Assembly 110-34 and the Senate 61-1.

Assemblyman Andrew Goodell, R-Jamestown, voted against the legislation on the grounds that it is adding to the state’s Medicaid budget at a time when the program is already one of the largest expenditures in the state budget every year.

“Every year we look at the cost of the Medicaid program and once again this year the cost is going up by a substantial amount,” Goodell said. “It is, I believe, the second-highest category of all expenses incurred by the state government. Of course all those expenses are borne by the taxpayers both on the state level and the county level. And while I have no doubt that all these services, including marriage counseling and family counseling are valuable, I would note that most private insurance doesn’t cover it and in fact our own insurance here in the state for us and as employees does not cover marriage and family therapists.”

Assemblyman Harry Bronson, D-Rochester, sponsored the chapter amendment in the Assembly and said the discussion shouldn’t center on the Medicaid budget but instead on access to mental health services. He also pointed to efforts by Attorney General Letitia James to force health insurers to pay for mental health and substance use disorder coverage. In August, James announced an agreement with UnitedHealthcare to resolve claims the insurer illegally limited coverage of outpatient psychotherapy. United will pay $1.3 million in penalties to New York state.

New York’s behavioral health parity law — originally enacted as “Timothy’s Law” in 2006 — and the federal Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) require insurance coverage for mental health and substance use disorder treatment to be no more restrictive than insurance coverage for physical health conditions. The agreements are the product of the first joint state-federal enforcement of these laws.

“So instead of suggesting our families aren’t receiving this under commercial carriers, the real analysis is if you are wealthy enough to self-pay for mental health services, or you have them covered on your commercial insurance coverage, then you get access to mental health. But if you’re poor and you’re on Medicaid, without this provision you don’t have access to mental health services. In fact, roughly 50% of the counties in New York state do not have one single mental health provider who accepts Medicaid. Not one. This bill will allow the professions who do desire to accept Medicaid as a reimbursible expense to their services to be able to fill that gap, predominantly in Upstate New York.”