Revise laws related to health insurance coverage of behavioral health screening
SB 244 requires a range of Montana health coverage arrangements to pay for behavioral health screenings and assessments that use a standardized, evidence-based instrument, with no out-of-pocket cost to the insured or subscriber. The bill makes the service optional rather than automatic: the insured must be informed the screening is voluntary and must request it. It applies to individual disability policies, state employee group benefit plans, Montana University System group benefits, health maintenance organizations, and self-funded multiple employer welfare arrangements, and it is intended to be codified within Montana’s health insurance statutes.
The bill also amends existing insurance statutes to add this behavioral health screening coverage to mandatory benefits already required in certain state-regulated plans. It updates cross-references in the HMO and self-funded MEWA statutes so those entities are subject to the new requirement, and it sets the act to take effect January 1, 2026, applying to policies, certificates, and contracts issued or renewed on or after that date. The bill’s structure suggests it is meant to standardize access to early behavioral health identification across multiple insurance markets in the state.
SB 244 expands mandatory health insurance benefits under Montana law by adding coverage for optional behavioral health screenings and assessments to individual disability insurance, state employee group plans, university system plans, HMOs, and self-funded multiple employer welfare arrangements. It amends sections 2-18-704, 33-31-111, and 33-35-306, MCA, and creates a new codified provision in Title 33, chapter 22. The bill affects insurers, group plan administrators, public employees, university employees, and covered dependents by requiring no-cost coverage when the insured requests the screening, subject to federal health savings account rules for high-deductible plans.
The overall sentiment around SB 244 appears generally favorable, with the bill advancing through both chambers by comfortable margins and passing committee votes without recorded opposition in the Senate committee. The vote history shows broad support for the concept of expanding behavioral health screening coverage, though the margins narrowed in some House votes, indicating some reservations. The bill ultimately reached the stage of a veto override attempt, which failed, suggesting that while the measure had legislative support, it did not secure enough backing to overcome executive opposition.
The main points of contention likely centered on the mandate itself and its cost or administrative impact on insurers and state plans, especially because the bill requires coverage at no out-of-pocket cost. Another likely issue was the interaction with federal HSA-qualified high-deductible health plans, which the bill addresses by limiting when the mandate applies to preserve federal tax-advantaged status. The optional nature of the screening may have been intended to address concerns about patient autonomy and overreach, while supporters likely emphasized early identification and access to behavioral health care. The failed veto override indicates that the governor’s objections, whatever their specific basis, remained significant enough to prevent enactment.