Election 2016: Assess the vice presidential candidates

While the impact they might have on behavioral healthcare largely would depend on how their respective running mates structure their administrations, the 2016 vice presidential candidates can be assessed by looking into the relevant policy history behind each them. The political records of Tim Kaine and Mike Pence offer a glimpse into their perspectives on key issues.

Kaine, who is former governor and the Virginia senator on the Democratic ticket, and Pence, who is governor of Indiana and the Republican vice presidential nominee, both have worked on legislation with major implications for the behavioral healthcare sector during their time as top elected officials in their respective states.

Tim Kaine

As governor of Virginia, Kaine signed a wide-ranging package of mental health legislation in 2008, appropriating $42 million in funding to overhaul the state’s mental health system, one year after a mass shooting at Virginia Tech that claimed the lives of 33 individuals. Funds were applied toward expanding emergency services, case management and outpatient services.

The laws also shifted the standard for committing an individual experiencing a mental health crisis into treatment involuntarily, requiring only that authorities demonstrate a “substantial likelihood” the individual could do serious harm to him/herself or others, whereas previously, authorities were required to prove the individual was in “imminent danger.”

Notable healthcare items from Kaine’s four years as a U.S. senator:

• He cosponsored several bills to combat the opioid crisis which were later combined into the Comprehensive Addiction and Recovery Act (CARA), which he also cosponsored.
• In April, Kaine said that while he would support changing sentencing laws for marijuana-related offenses, he is not in favor of legalizing marijuana at the federal or state level.

Mike Pence

In January 2015, Pence announced that Indiana received federal approval for its Medicaid expansion under the Affordable Care Act (ACA), extending benefits to people with annual incomes below 138% of the federal poverty level. Indiana’s Medicaid expansion, however, requires participants to make monthly contributions to accounts similar to health savings accounts, a twist not included in any other state.

Andrew Sperling, director of legislative advocacy for the National Alliance for Mental Illness, says that while the mandatory spending account provision causes discomfort for ACA advocates, Pence’s willingness to expand Medicaid in his state is worth noting.

“As a Republican governor, to try to work across the aisle and work with the Obama administration to expand Medicaid was an important step,” Sperling tells Behavioral Healthcare. “Very few Republican governors were willing to do that.”

In February 2015, Pence took a less progressive approach to an emerging HIV public health crisis, which left 181 people in Southeastern Indiana HIV positive. The HIV outbreak centered in Scott County was attributed to needle sharing as part of the ongoing opioid crisis. Public health officials called on Pence to approve statewide exchanges to help curb the sharing of infected needles. Pence, however, signed off only on a temporary needle exchange program for Scott County and a requirement for additional counties to get state approval before starting exchanges of their own. While Pence was credited for finally taking action in response to the public health crisis, his decision drew criticism from health officials and lawmakers for its limited scope.