Bill to cover prescription drugs for serious mental illness clears Assembly committee
Pintor Marin, Park, and Bagolie bill would require prescription coverage for individuals that experience serious mental illness
NEW JERSEY – Legislation aimed at improving access to mental health medication recently cleared the Assembly Financial Institutions and Insurance Committee.
Bill A4838 would require insurance plans to cover prescription drugs for serious mental illness without prior authorization or utilization management, including step therapy protocols. The bill is sponsored by Assemblywomen Eliana Pintor Marin, Ellen Park, and Rosy Bagolie.
According to the National Alliance on Mental Illness (NAMI), 1.1 million adults in New Jersey have been diagnosed with a mental health condition, and 284,000 are living with a serious mental illness.
“Mental illness affects families in every neighborhood and every generation,” said Assemblywoman Pintor Marin (D-Essex, Hudson). “As legislators, we have an obligation to make treatment more accessible – not more complicated. This bill removes unnecessary barriers and ensures that individuals can access the medications they need without delay.”
The bill would require health insurance carriers, as well as State Medicaid and NJ FamilyCare programs, to cover drugs for serious mental illness without requiring prior authorization or other utilization management steps. This provision would only apply to patients who are 18 years or older and whose psychiatrist or OBGYN, during the postpartum period, prescribe the medication.
“With the aftermath of the COVID-19 pandemic, now is the perfect time to ensure that people receive the care they need to combat mental health challenges,” said Assemblywoman Park (D-Bergen). “Covering these prescriptions without prior authorization or other requirements will make a difference in the quality of life for our residents.”
“Advancing this legislation through committee is a vital step in tearing down the barriers that prevent people from accessing the mental healthcare they urgently need,” said Assemblywoman Bagolie (D-Essex, Passaic). “This progress brings us closer to a future where no one is left waiting for treatment when their life is on the line. By removing red tape, like prior authorization, we’re giving people a real fighting chance at the care they deserve.”
Under the bill, serious mental illnesses include numerous psychiatric conditions, such as post-traumatic stress disorders, schizophrenia, schizo-affective disorders and bipolar disorders and major depressive disorders – whether a single episode or recurrent, including, but not limited to any major depressive disorder with peripartum onset.
