APA Urges Congress to Fund Mental Health and Substance Use Disorder Provisions Within the Build Back Better Act

Letter to Hill leadership details mental health priorities
as reconciliation package is considered

Washington, D.C., Oct. 8, 2021 – As Congress considers a reconciliation package to address funding President Biden’s Build Back Better Act, the American Psychiatric Association (APA) is expressing strong support for several provisions within the Act that are critical for enhancing efforts to improve mental health across the nation at this time of great need. In a letter sent to House and Senate leadership, the APA detailed essential provisions to include within the package.  They are:

Health insurance cost-sharing to assist patients in getting acute and chronic mental and physical health conditions under control earlier and to ensure overall patient health resulting in cost savings for the health system. Especially important within this provision is assistance to individuals with incomes below 138% of the federal poverty level (FPL) and the expansion of ACA Marketplace premium tax credits to those with incomes below 100% of the FPL.

Closing the Medicaid coverage gap by establishing a federal Medicaid program for individuals residing in non-Medicaid states beginning in 2025 and providing states with a permanent 7% federal medical assistance percentage (FMAP) increase to improve and strengthen home and community-based services. In addition, APA supports the requirement that states provide full Medicaid benefits to pregnant and postpartum individuals as well as coverage of incarcerated individuals 30 days prior to their release from detention.

Permanent funding authorization for the Children’s Health Insurance Program (CHIP), allowing states the option to increase and expand CHIP income eligibility levels about the existing statutory ceiling and the 12-month extension of continuous CHIP coverage to pregnant women, postpartum women, and children.

Investment in the training, cultural competence and expansion of the medical workforce to address current significant shortages, such as the establishment of the Rural and Underserved Pathway to Practice Training Program for post-baccalaureate and medical students. In addition, APA supports funding for: 1,000 additional physician residency training positions for hospitals tied to mentorship and cultural competency; grants for qualified teaching and behavioral health care centers; and 700 positions at VA medical centers over seven years.

Supporting health equity through programs to advance access to evidence-based and culturally competent care including: additional funding for the Minority Fellowship Program (MFP); training grants for health professionals to reduce discrimination and bias in the provision of health care; and grants to address maternal health conditions and substance use disorders.

Strengthening parity through provisions that levy civil monetary penalties on health plans, issuers and third-party administrators who violate parity law requirements as established through the Mental Health Parity and Addiction Equity Act.

Suicide Lifeline funding to expand programs to provide more resources and support to individuals in crisis as the Lifeline transitions to the new 9-8-8 number next summer.

Environmental and climate justice block grants to help mitigate the adverse health and mental health effects and public health outcomes related to pollution and climate change.

“The pandemic clearly and considerably exacerbated the mental health and substance use crises that already existed, resulting in a second epidemic our nation must address,” said Saul Levin, M.D., M.P.A., APA CEO and Medical Director. “This reconciliation package presents an opportunity to take important steps to expand access to quality mental health and substance use disorder care to meet our country’s critical need and benefit millions of patients across the country.”

American Psychiatric Association
The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 37,400 physician members specializing in the diagnosis, treatment, prevention and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information please visit www.psychiatry.org.


To advance the quality and effectiveness of psychiatric care through advocacy, professional education and camaraderie.



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