Why Should Delaware Care?
A federal law requires that insurance companies do not impose additional costs onto those seeking mental health and addiction treatments. But a recent change to that law which expanded protections for patients and placed more responsibility on insurers to maintain strong treatment networks is likely to be rolled back by the Trump administration. Delaware hopes to implement its own version of the protection.
Delaware state senators advanced a bill out of committee on Tuesday that would bolster mental health and addiction treatment by requiring insurers improve the number of providers in their networks. The bill also includes language hamstringing insurers’ ability to deny care.
Senate Bill 22, introduced by Senate Majority Leader Bryan Townsend (D-Newark), would codify parts of a federal law currently being challenged in court by insurers. That law likely will be rewritten by the Trump administration.
During a Senate Health and Social Services Committee hearing on Tuesday, multiple trade organizations and health nonprofits expressed support for SB 22 and how it could help people access treatment sooner.
A representative from Highmark, Delaware’s largest health insurer, opposed the bill during public comment, claiming the changes could reduce quality of care and worsen health outcomes for patients.
In a statement to Spotlight Delaware, a Highmark spokesperson said the insurer is “committed to caring for the mental health of all Delawareans,” but challenged SB 22 on the grounds it is based on federal regulations that are currently under review.
“We are reviewing the bill closely and look forward to continued collaboration with legislators and stakeholders,” the spokesperson said.
Lawmakers ultimately advanced SB 22 out of committee Tuesday afternoon, sending the bill to the full Senate for further consideration.
Senate Bill 22 comes as lawmakers also consider another bill that would bolster how the state funds its primary care infrastructure — an attempt to build out more preventative healthcare options and avoid costly emergency room trips.
And while SB 22 looks to improve access to mental health treatment in the state, there are still questions about its impact on the quality of care. Delaware relies on its inpatient facilities for many of the state’s most acute mental health needs.
But Spotlight Delaware has recently reported on two of the state’s largest inpatient mental health facilities, and how some patients felt they left treatment worse than when they entered.
What is mental health parity?
Delaware’s proposal aims to strengthen what is called “mental health parity,” which is a federal rule that was created to ensure patients had equal access to mental health and medical services.
JoAnn Volk, a research professor at the Center on Health Insurance Reforms at Georgetown University, said the Mental Health Parity Act was created in the late 1990s requiring insurers to not impose higher costs for mental health treatments compared to other medical procedures.
By 2008, federal lawmakers expanded the law to include addiction treatments, creating what is now the Mental Health Parity and Addiction Equity Act (MHPAEA).
Volk said the goal of the bill was to not only prevent financial barriers to seeking care, but also prevent insurers from putting treatment limits on patients, like the amount of days they spend in an inpatient setting or at doctor’s visits.
And in late 2024, multiple federal departments under the Biden administration approved changes to the MHPAEA that required insurers to measure outcome data and ensure their policies for mental health and addiction treatments do not reduce access to care.
By the time the Trump administration took over in 2025, it said it would not enforce Biden’s changes to the MHPAEA.
Volk said in response to the Trump administration’s pause, some states have charged ahead with their own legislation that mirrors that 2024 change, regardless of what the federal government decides to do with the change.
She added that Delaware’s law includes some stronger consumer protections like requiring insurers to cover an out-of-network trip if there are not appropriate in-network services.
Insurance Commissioner Trinidad Navarro said in an interview with Spotlight Delaware that Senate Bill 22 would require insurers to maintain a provider network that allows patients with non-urgent mental health needs to receive treatment within 10 days.
Should those providers not have availability or be able to provide care in a timely manner, insurers must offer “single-case-agreements” that allows patients to receive care out of network at no additional cost.
Navarro added that Delawareans are five times more likely to go out of network for mental healthcare, citing a 2024 study from the Research Triangle Institute.
“There’s a shortage of certain types of intensive treatment, where people have had to leave the state for the appropriate care, not any fault of their own,” Navarro said. “And they shouldn’t be penalized for that.”
Committee hearing testimony
Discussion about SB 22 took up most of Tuesday’s committee meeting, with testimony from nurses, a mental health nonprofit and an outside policy organization that helped to draft the bill.
The policy professional, David Lloyd of Inseparable, said SB 22 drills down on specific language to prevent insurers from denying claims because they do not perceive them as medically necessary.
He also said that when patients take care of their mental health, it helps to bring down other medical costs treating chronic diseases. Lloyd also said other states that implemented similar legislation saw insurance denials for treatment go down.
State Sen. Eric Buckson (R-South Dover) expressed his support for the bill, citing his experience with addiction in his family and athletes he knows who have lost their lives to suicide.
“This is an absolute positive step in the right direction,” Buckson said during the hearing.
He also asked about the potential costs on taxpayers. In response, Lloyd reiterated his point about costs coming down for insurers when people seeking mental health treatment are able to better manage chronic illnesses.
Anastasia Robinson, a school nurse with the Indian River School District, said she has helped students and families navigate an insurance system that is “often working against them.” She said in recent years, mental health for children has become more complex and acute.
In preparation for Tuesday’s hearing, Robinson called multiple families she knew to ask them about their experiences trying to access treatment for addiction, experiences she called “nightmare stories.”
She added that delays in approving care can lead them to not seek treatment in the future.
“What sort of desperation do these parents feel as they wait on some insurance company to essentially agree to save their child’s life?” Robinson said.
Committee members advanced SB 22 with five favorable votes. The bill will now be debated and voted on by the full Senate, but it is unclear when that vote will take place.
