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APA, National Council disapprove of American Health Care Act
Several mental health organizations have expressed concern regarding the American Health Care Act.
“While a number of details about the potential impact of the proposed [Affordable Care Act (ACA)] replacement remain unknown, our current understanding of the proposal raises many concerns for people with mental illness,” APA President Maria A. Oquendo, MD, PhD, said in a press release. “Particularly concerning are proposed changes to the Medicaid expansion program. Nearly one-third of people receiving coverage through Medicaid expansion have mental health or substance use disorders.”
The National Council for Behavioral Health released a statement reporting that the proposed ACA replacement bill could “devastate Americans’ mental health and addiction coverage and care.”
Areas of concern include:
- significant cuts in Medicaid funding to pay for reforms in commercial health care;
- restricting federal support for states through proposed per-capita caps in Medicaid, which could increase fiscal pressure on states and limit their ability to provide mental health services; and
- limited ability to combat the opioid epidemic due to funding caps to Medicaid.
“The ACA was not perfect, but these Medicaid provisions are not the answer,” the National Council wrote. “They will result in increases hospitalizations, incarcerations, disability benefits and avoidable deaths. When it comes to Medicaid, we need Congress to find a solution that will protect our friends, family and neighbors living with addictions and mental illness — not strip access to live-saving care.”
To maintain services for individuals with mental health and substance use disorders and their families, the APA recommended the following:
- maintain current level of coverage for mental health and addiction disorders in health insurance plans;
- maintain protections in private insurance by prohibiting the following: Denial of coverage due to preexisting conditions; lifetime and annual dollar limits on health benefits; and discrimination based on health status and history;
- ensure sufficient funding for mental health and substance use disorders in Medicaid, while not shifting cost to states, which could force states to limit eligibility requirements, provider reimbursement or benefits; and
- fully implement and enforce the Mental Health Parity and Addiction Equality Act.
“As Congress considers reforms to health insurance coverage it is critical to maintain the significant progress made over the past 3 years, through bipartisan efforts, to improve access to mental health care,” Saul Levin, MD, MPA, CEO and Medical Director of the APA, said in the release. “APA is committed to working with members of both parties in Congress to help ensure adequate access to quality mental health care for all those in need.”