American Health Care Act

Plan to “Decimate” Mental Health Care

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Leading mental health advocates are strongly condemning the Senate Republican health care bill proposed on June 22 for cutting Medicaid programs that provide vital lifelines to Americans struggling with mental illness.

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The criticism follows the harsh reaction voiced earlier this year to the American Health Care Act proposed by House Republicans to replace the Obama administration’s Patient Protection and Affordable Care Act, or Obamacare.

The National Alliance on Mental Illness, the nation’s largest grassroots mental health organization, said this week that the Senate Republicans’ Better Care Reconciliation Act “will slash Medicaid benefits for critical mental health services millions of Americans need to lead productive lives. NAMI opposes this effort to decimate our nation’s already struggling mental health system.”

NAMI explained the importance of Medicaid to mental health care:

“Medicaid is the largest source of funding for public mental health services in our nation. One-third of people covered by Medicaid expansion lives with a mental health or substance use condition and Medicaid serves as a lifeline for people with mental illness who typically fall through the cracks. It provides critical coverage so people have access and receive the mental health treatment they need to finish school, get back to work and contribute to their communities.”

NAMI said that the Senate and House proposals to convert Medicaid to a “per capita cap” for states will result in “devastating cuts to mental health services.”

“NAMI is deeply concerned that the Better Care Reconciliation Act will force people with mental illness out of the health care coverage they need and on to the streets and into costly emergency rooms, hospitals and jails. We encourage Senators to reject this harmful bill, and instead, ensure that Americans have receive the mental health care they need to lead healthy and productive lives.”

Paul Gionfriddo, president and CEO of Mental Health America, echoed NAMI’s concerns. He said the Senate Republican legislation would “do significant harm to people with all chronic conditions, including mental illnesses.” He said the proposal “replaces much of both the core and expanded Medicaid program—lifelines to people with serious and persistent mental illnesses.”

Gionfriddo called for changes to Obamacare to be made “in the context of rational health policy. We would all be well served if Congress were to go back to the drawing board and get this right. Too many lives depend on it.”

Similar to the House legislation, the Senate version would cut health care coverage to 22 million people, according to the Congressional Budget Office. “Repealing and replacing” Obamacare was a major campaign promise made by President Donald Trump. Trump’s Republican Party controls both houses of Congress.

NAMI is organizing a “Virtual Hill Day” on Thursday June 29 to lobby Congress against cuts in mental health coverage, demanding: “We need more mental health care, not less.”

The organization says that 1,000 mental health advocates will meet face-to-face with members of Congress; it encourages others to voice their opposition to cuts by phoning, emailing, or tweeting at their congressional representatives.

GOP Threat to Mental Health Treatment

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Leading health care stakeholders are condemning the Republican health care plan, with some expressing grave concerns about its impact on mental health treatment. The National Alliance on Mental Health (NAMI) says the Republican plan puts “millions of Americans with mental illness at risk.”

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Many major organizations immediately rejected the health care plan proposed this week by Republicans in the U.S. House of Representatives to replace the Patient Protection and Affordable Care Act, also known as Obamacare. Among them: the American Medical Association, the American Nurses Association, the American Hospital Association, the Association of American Medical Colleges, the Catholic Health Association of the United States, and the Children’s Hospital Association. The AARP, which represents 38 million older Americans, said: “This bill is a $200 billion giveaway to special interests like insurance and drug companies. They make out like bandits while real people are left with higher premiums and less security.”

In a letter to House Republican leaders, AMA CEO James L. Madara criticized the “potentially life altering impact your decisions will have on millions of Americans who may see their public, individual or even employer-provided health care coverage changed or eliminated.” Madara warned that changes to Medicaid could undercut state efforts to cope with increased demand for mental health and substance abuse treatment as a result of the ongoing crisis of opioid abuse and addiction. (An estimated 1.3 million Americans receive treatment for mental health and substance abuse disorders covered by Medicaid’s expansion under Obamacare.)

ANA President Pamela F. Cipriano also complained that the Republican plan would eliminate the Prevention and Public Health Fund and cut off critical coverage for millions of Americans with mental health and substance-use disorders.

Here’s NAMI’s statement about the Republican plan’s threat to mental health treatment:

The American Health Care Act (AHCA) would reduce funding for health coverage—from insurance plans to Medicaid—and put mental health care at risk. It caps Medicaid funding, which will lead to deep cuts and jeopardize mental health services.

Congress shouldn’t put millions of Americans with mental illness at risk. Cutting corners in health coverage will keep people from getting the treatment they need and will push people with mental illness into costly emergency rooms, hospitals and jails.

Investing early in affordable, quality mental health care promotes recovery and saves taxpayer dollars in the long term by avoiding disability, criminal justice involvement and frequent hospital stays.

Here are the provisions NAMI says will harm people with mental illness:

Individual and Small Group Health Insurance

Current federal help to buy health insurance would be reduced, leaving millions of people, including people with mental illness, unable to afford mental health care.

Traditional Medicaid

Traditional Medicaid would be converted to a “per capita cap” system, which means states would get a fixed amount of federal funding per person. Instead of flexibility, this would lead to deep cuts over time and jeopardize mental health services.

Federal Medicaid funding would be frozen at current levels, adjusted for inflation. Funding for mental health and substance use services is already inadequate and could not be improved without cutting other needed health care.

Medicaid Expansion

Nearly 1 out of 3 people covered by Medicaid expansion live with a mental health or substance use condition. This bill would end new enrollment in 2020, leaving people with mental health and substance use conditions without the Medicaid services they need to stay in school, on the job and in recovery.

Medicaid expansion plans would no longer have to cover mental health and substance use care, abandoning Congress’ commitment to mental health and substance use coverage.

People covered by Medicaid expansion before 2020 would be dropped from their plan if they have a lapse of coverage of more than a month. For people with mental illness, this is a high price to pay for forgetting to pay a premium while someone is in the hospital or experiencing severe symptoms.

NAMI says that one in five Americans experiences a mental health condition, but only half get needed treatment. It argues that coverage for mental health care helps people get treatment when they need it, helping them to stay in school, on the job and in recovery.