NUHW members at Kaiser Permanente in Southern California recently waged a historic 196-day strike seeking to win equity for behavioral health within a Kaiser system that has been cited numerous times for mental health violations over the past two decades.
The strike made important gains, but Kaiser — and other insurance companies – still underpay and undervalue mental health professionals, which makes it harder for Californians to get the care they need.
With the strike now over, NUHW is focused on two bills that it has sponsored that would help Californians seeking mental health care and those who provide it:
SB 747: Behavioral Health Wage Transparency
SB 747 was authored by State Senator Scott Wiener, of San Francisco, to start addressing the severe pay gap between mental health professionals and similar workers who provide medical care.
Insurance companies and HMOs like Kaiser Permanente often make excuses for poor access to mental health care by saying there’s a shortage of therapists.
But if there’s a shortage, employers like HMOs and medical groups should be increasing salaries for mental health professionals versus comparable healthcare workers on the medical side. However, that is definitely not happening at Kaiser, which sets the market for healthcare salaries in California.
At Kaiser, mental health therapists are paid between 20 to 50 percent less than workers with comparable educational and licensing requirements like occupational and physical therapists. Such a striking disparity will make it harder to educate and train enough mental health therapists to meet the needs of Californians.
SB 747 is a first step toward creating transparency around the wage gap. It would require large health plans and medical groups to report salary data to the California Department of Industrial Relations.
By making that data available for analysis, it will provide a true picture of the wage disparity between comparable mental health and medical occupations in California.
And it can help inform policies to close the gap so California can produce and attract more mental health workers and meet the growing demand for care.
AB 1429: Behavioral Health Reimbursement
*UPDATE: This bill did not make it out of the Assembly Appropriations Committee*
AB 1429, was authored by Assemblymember Dr. Jasmeet Bains, of Delano, specifically to help Kaiser patients seeking mental health care and addiction medicine treatment.
The bill came in response to a 2023 Settlement Agreement, in which Kaiser agreed to pay a $200 million penalty, including a $50 million fine, for serious deficiencies in its mental health services.
As part of the settlement with California regulators, Kaiser acknowledged that it didn’t have enough therapists, which has resulted in patients waiting far too long for treatment appointments.
Because Kaiser delays care, AB 1429 would have made it much easier for Kaiser patients to get reimbursed for mental health treatment or prescriptions they attempted to get from Kaiser but had to pay for out of pocket from a non-Kaiser provider.
Instead of going through a bureaucratic process controlled by Kaiser, the bill would have required Kaiser to reimburse any member who could attest in writing that they had to pay out of pocket because they could not get adequate mental health care or addiction medicine treatment from Kaiser.
The requirement would have dated back to services provided in May 2022, which is when regulators began investigations that resulted in the $200 million Settlement Agreement. It would have remained in effect until state authorities determine that Kaiser had fully corrected its deficiencies.
