March 7, 2017
Carol Meyers
Director of Communications
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703.294.6003
Statement on Replacing the Affordable Care Act
Health Reform Must Consider and Provide for People with Serious Mental Illness
Yesterday, leadership in the U.S. House of Representatives began the conversation on potential strategies for replacing the Affordable Care Act by introducing bills known collectively as the American Health Care Act. We are deeply concerned that, in their current form, these bills would have a negative impact on those with the most severe mental illnesses.
The Republican-led 114th Congress recognized that our nation was in the midst of a mental health treatment crisis, and passed landmark legislation that finally focused federal attention and support on those with the most severe mental illnesses. As discussions continue, we encourage decision makers to ensure that any reforms reflect the urgency of the mental health treatment crisis and do not cause us to lose any of our hard-fought momentum.We are concerned with the current bills' treatment of Medicaid services -- in particular, those provisions that would seek to freeze enrollment of Medicaid expansion in 2020. As Senators Capito, Gardner, Murkowski and Portman have noted, Medicaid is the largest payer of mental health services in the United States and nearly one-third of individuals covered under Medicaid expansion have a mental health or substance abuse disorder. Provisions that would reduce such coverage or end opportunities for enrollment guarantee that those in need of treatment will suffer, and related societal costs will rise. Severe mental illness typically strikes individuals at the start of their working careers, in many cases without warning. Many individuals who will require such treatment years in the future have no way of currently knowing whether they will have a severe mental illness, and there is no way to ensure they are included within the current expansion.
The bills would also disastrously eliminate mental health as an essential health benefit from Medicaid, and with it the requirements to provide parity between mental health and other medical and surgical benefits. We know from the recent past that such requirements are necessary to ensure that individuals with mental illnesses have access to the treatment they need to live full and functional lives. Provisions limiting or eliminating mental health as an essential health benefit will only serve to raise costs, as individuals without access to mental health care deteriorate and become sicker. Experience shows us that without access to appropriate care, these individuals often end up receiving more expensive and less therapeutic care -- provided by crisis centers, emergency rooms, homeless shelters and jails.
As discussions continue, we strongly encourage policymakers to recognize that all decisions about health reform must consider and provide for the needs of the most severely mentally ill. Failure to do so will forfeit the momentum towards reforming our broken mental health system at tremendous human and financial cost.
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The Treatment Advocacy Center is a national nonprofit organization dedicated to eliminating barriers to the timely and effective treatment of severe mental illness. The organization promotes laws, policies and practices for the delivery of psychiatric care and supports the development of innovative treatments for and research into the causes of severe and persistent psychiatric illnesses, such as schizophrenia and bipolar disorder.
The American Psychiatric Association has awarded the Treatment Advocacy Center its presidential commendation for "sustained extraordinary advocacy on behalf of the most vulnerable mentally ill patients who lack the insight to seek and continue effective care and benefit from assisted outpatient treatment." The organization does not accept funding from the pharmaceutical industry.