We must be vigilant for mental health issues

Thanks to the actions of U.S. Sens. Chuck Grassley and Tom Harkin and others in the Iowa congressional delegation, Iowans living with mental illness and other chronic health conditions will continue to have access to life-sustaining and lifesaving medicines.

Last month, patient-advocacy organizations, health care stakeholders and members of Congress led the charge to prevent the U.S. Centers for Medicare and Medicaid Services from limiting access to six protected classes of medicines in Medicare Part D.

For example, the proposed rule would have limited Medicare's coverage of antidepressants and antipsychotics to only two medications in each class and category. Yet for many of the most vulnerable Medicare beneficiaries, including the mentally ill, medicines are not interchangeable and patients often require a delicate combination of several different treatment options.

Medications are an integral component of effective treatment for people living with serious mental illness such as schizophrenia, bipolar disorder and major depression disorder. These illnesses are biologically based brain disorders that can severely impact a person's ability to think, feel and relate to others.

The goal of prescription therapies for Iowans living with mental illness is to sustain good health and prevent declines that warrant costly acute or emergency care. The consequences of not having access to the right medications can be devastating for mental health patients, and can include loss of employment, hospitalizations, homelessness, criminal justice involvement or even death.

If the proposed CMS rule had gone into effect, many Iowans and millions of Medicare beneficiaries would have been without treatments that allow them to lead full and productive lives.

People living with mental illness have complex, varying clinical needs that cannot be characterized as typical. No single mental health medication works for all patients and there may be various side effects that one patient experiences versus another. Treatment needs vary patient to patient.

Medicare Part D provides seniors and disabled Americans with access to affordable prescription medications, which produce long-term benefits for both Medicare patients and taxpayers. Since its inception in 2008, Medicare Part D has been effective at both improving health outcomes for patients and lowering costs for taxpayers. NAMI Iowa has supported the Medicare Part D program and worked to ensure its full implementation in serving patients with mental illness.

A study by Harvard Medical School found that Medicare Part D saves tax payers an estimated $12 billion each year by keeping beneficiaries healthy and out of hospitals and retirement homes.

Medicare Part D is also one of the most cost-effective federal programs in existence. Over the last 10 years, the program has cost taxpayers about 40 percent less than projected. Its success is in part because of open access to medicines for patients. Eliminating access to a broad range of antidepressants and antipsychotic medications would have been disastrous for patients living with mental illness.

Every member of the Senate Finance Committee, including Grassley, senior member, expressed opposition to the proposed CMS changes to the protected class policy. Fortunately, as a result of these efforts, CMS withdrew the proposed rule to limit access to the protected classes within Medicare Part D.

We will need to be vigilant to ensure that those living with mental health conditions in Iowa continue to have access to the care they need.

' Nancy Hale is the executive director of the Iowa chapter of the National Alliance on Mental Illness, http://namiiowa.com/. Comments: hale1605@aol.com