The acknowledgement and treatment for serious mental illness has come a long way. However, we still need significant improvement in our approach to treating serious mental illnesses (SMI) and other brain injuries. I am working with Republican and Democratic colleagues to support HB23-1130, which is designed to limit “step therapy” for those with SMI.  For too long, SMI has been approached and treated in a dramatically different manner than physical illness. We have learned during the past several decades brain health is just as serious as physical health. We have learned this agonizing lesson through the experiences and injuries of our veterans.

During my 26 years of service in the United States Army, it was my honor and duty to lead brave men and women into combat. I know firsthand the physical, mental and emotional toll that combat inflicts on soldiers. Unfortunately, many of those selfless heroes return with Post Traumatic Stress Disorder (PTSD) or Traumatic Brain Injuries (TBI). Oftentimes, treatment for TBI, PTSD and other battlefield injuries can lead to SMI. Sadly, according to Mental Health Colorado, our state is at or near the bottom when it comes to treatment of SMIs. 

One way to ensure patients with SMI have the best chance for recovery is to allow their medical doctor to prescribe the medication that they deem most appropriate for treating the conditions their patients have. Applied under current law, step therapy is the practice of insurance carriers to require a series of alternative and generally less-expensive therapies before they will cover the medication recommended by the medical professional. I completely understand the need and efforts to reduce costs, especially as government continues to pile mandates and price controls onto insurers and providers. I also believe that it is imperative to treat people with SMI. I am supporting HB 1130 because it is a reasonable approach that allows health insurers to require a cheaper, though perhaps less effective, medication just once. After that, the most effective treatment is determined in consultation with the physician, patient and their family, to decide the most appropriate and effective means.

It is helpful to note that the military does not use step therapy, because it has a specific and often dangerous task to perform. Therefore, military medical personnel focus solely on the needed treatment for the wounded, injured or sick service members. They diagnose the problem and do what is required to fix it. That should be the reasonable approach in the civilian medical sector as well.

We learned a tragic lesson from the treatment of our Vietnam veterans. Too many of those veterans came home and did not receive proper treatment for PTSD, TBI and other well-known diseases, including those developed from exposure to Agent Orange. We must not repeat the same mistakes in treating SMI. We understand much better about PTSD and how SMI can develop. We must focus on effective and rapid treatment.

In January of this year, the Regional Economic Consulting Group found the State of Florida would experience significant economic benefits and cost savings from enactment of similar step therapy reform as is being proposed in Colorado. In addition, in 2019 a study conducted by the Michigan Department of Health and Human Services found curtailing access to innovative drugs for treatment of SMIs in the Medicaid realm would decrease costs, and that denying access to such medications would likely increase costs.

I am absolutely opposed to a single-payer health care system, or any type of government-run and government-controlled health care. We must treat mental illness with the same urgency and immediate care as physical injury to reduce overall costs to our health care system and to society. HB 1130 is the right step in that right direction.

Anthony Hartsook  (R-Douglas County) Represents District 44 in the Colorado State House, and serves on the House Health & Insurance Committee. He is a retired U.S. Army Lieutenant Colonel.