Committee hears bill to require insurers to cover behavioral-health screening at no cost

The House Business and Labor Committee heard testimony on Senate Bill 244 on March 17, a measure that would require health-insurance plans to cover behavioral-health screening assessments at no out-of-pocket cost to patients, including coverage consistent with state employee group benefit plans.

Sponsor remarks and proponents' testimony said the bill aims to reduce financial and stigma-related barriers to mental-health screening. "This is a $30 cost on your bill when it goes to that level of screening," the bill sponsor said, arguing insurers support the change and that early screening can avoid larger costs later.

Proponents told the committee that routine screening identifies people who might otherwise be missed. JJ Carmody, representing Billings Clinic Logan Health, cited national data showing many people who die by suicide have seen a health-care provider shortly beforehand and said screenings used in primary care — including the PHQ‑9 depression questionnaire — open the door to earlier conversations and referrals. "Without these frequent screenings we fear many of our patients will go unidentified, resulting in more severe consequences," Carmody said. Billings Clinic reported conducting more than 19,000 behavioral-health screenings in 2024 and said those resulted in about 700 referrals to collaborative care.

Kali Wicks of Inseparable and other proponents echoed those points, emphasizing early detection, integrated care and improved access. Jean Branscum, CEO of the Montana Medical Association, said the screening tools reduce stigma and support prevention. Stacy Anderson, representing several primary-care organizations, pointed to Montana’s Mental Health Parity law and said charging patients for screening can conflict with parity expectations.

An opponent, Steven Pierce of the Citizens Commission on Human Rights, urged caution about universal screening. Pierce argued screening tools can generate false positives and lead to unnecessary treatment, saying "there's a lack of reliability" in blanket approaches and that screening should be used on an as‑needed basis rather than universally.

Amy Jenks, administrator for the Health Care Benefits Division at the Department of Administration, appeared as an informational witness and answered questions about how the state employee plan could be affected. The sponsor told the committee there is no fiscal impact to the state and said insurers indicated the change would not raise premiums; proponents and the sponsor noted insurers had participated in pre‑hearing discussions.

Committee members asked whether objective instruments exist and how screening results are handled. Proponents repeatedly said screening tools such as the PHQ‑9 are standardized instruments that prompt clinicians to follow up, and that a positive screen typically leads to conversation and clinical judgment rather than automatic referral to specialty care.

The committee did not take a vote on the bill at the hearing. Proponents asked for a "do pass" recommendation; opponents asked the committee to weigh reliability and the risks of over‑identification.

Why it matters: Supporters said the measure would reduce a financial barrier to routine behavioral-health screening used in primary care and could improve early identification of mental‑health needs; critics warned of risks from universal screening and false positives. The committee will decide next steps in a later meeting.