WASHINGTON — Two leading mental health associations have called on the Senate to reject the flaws in the American Health Care Act and instead craft a bill that would result in more people having coverage for mental health and substance use treatment, and not penalize people with pre-existing conditions.
“We strongly oppose the American Health Care Act, which according to the Congressional Budget Office, would result in 14 million more people uninsured in 2018 than under current law, and 23 million more people without insurance by 2026,” the American Psychiatric Association and American Psychological Association said in a letter to the Senate majority and minority leaders. “Millions more would lose access to treatment, with mental health and substance use services no longer being covered under their benefit package. This is the wrong direction for our country.”
The letter, to Sen. Mitch McConnell, R-Ky., and Sen. Charles Schumer, D-N.Y., was signed by Saul Levin, M.D., M.P.A., CEO and medical director of the American Psychiatric Association, and Arthur C. Evans Jr., CEO and executive vice president of the American Psychological Association.
The two executives called on the Senate to retain Medicaid eligibility for Americans below 138 percent of the federal poverty level and to retain the current Medicaid financing structure, without the use of per capita caps or block grants.
“Low-income and uninsured adults have sharply higher rates of serious mental illness as those with insurance and higher incomes,” they wrote. “Medicaid expansion has been particularly helpful in addressing the opioid epidemic, as illustrated by the 700 percent increase in use of substance use treatment services among Kentucky beneficiaries after the state expanded its Medicaid program, and Medicaid’s coverage of 37 percent of spending on buprenorphine in New York.”
The danger of capping federal Medicaid payments is shown by the opioid addiction epidemic, they said. “Private insurance payments for opioid abuse and dependence services increased by 1,375 percent between 2011 and 2015 (from $32 million to $446 million),” they wrote. “Under a system of Medicaid per capita capped payments, tens of thousands of individuals struggling with opioid addiction would have been denied Medicaid coverage and treatment, and thousands more would have died. States already have significant flexibility in tailoring their Medicaid programs, and can be provided more flexibility without capping federal payments.”
The two executives urged the Senate to continue to require plans to cover an essential health benefits package that includes mental health and substance use disorder services and behavioral health treatment, and to prohibit insurers from charging higher premiums for people with pre-existing conditions. They also noted the need to invest in research and programs, including retaining the Prevention and Public Health Fund, to save lives and money by keeping Americans healthy.
“Our nation cannot afford to go back to the days when insurers selectively enrolled individuals to avoid financial responsibility for needed services. Nor can we afford to return to viewing mental health and substance use services as optional,” they wrote. “Rather, we must further reduce the uninsured rate, develop integrated systems of care, and continue to foster an environment in which health plans compete on how efficiently and effectively they can provide services.”
The American Psychiatric Association is the oldest medical association in the country founded in 1844. The APA is also the largest psychiatric association in the world with more than 37,000 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.
The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States. APA's membership includes nearly 115,700 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance the creation, communication and application of psychological knowledge to benefit society and improve people's lives.