The GOP's proposed health law, the American Health Care Act, has some mental health and addiction treatment advocates worried.
The Affordable Care Act, also known as Obamacare, forced Medicaid plans to cover mental health and addiction treatment just like other physical health conditions. The health law also gave states the option to expand Medicaid to cover people who make up to 138 percent of the federal poverty level. Thirty-one states have since expanded to cover millions of poor people, including Indiana, which has extended coverage to about 260,000 Hoosiers through the Healthy Indiana Plan, or HIP 2.0.
But Doug Walter, director for government relations at the American Psychological Association, says those improvements would be rolled back under the GOP’s new proposal, harming many people who need mental health and addiction treatment.
“People who are poorer are more likely to suffer from mental illness,” he says. “These are patients at high risk of domestic violence, substance abuse, untreated psychiatric conditions…it goes on and on and on.”
A recent report from the Congressional Budget Office says 14 million people could lose their coverage by 2018 — 24 million people by 2026. Fourteen million of those people would come from the Medicaid population.
And the law would not require Medicaid to cover mental health and substance use treatment. Changes under the AHCA would mean that the federal government pays a smaller portion of Medicaid costs. So Walter says states would likely opt out of providing mental health and addiction treatment. “Do states have the ability to pay for those services? I would say that many do not,” he says.
Dr. R. Jeffrey Goldsmith, president of the American Society of Addiction Medicine, penned a letter to members of Congress, urging them to reconsider the parts of the AHCA that would “reduce coverage for and access to addiction treatment services, changes that will be particularly painful in the midst of the ongoing opioid epidemic.”
Dr. Maria Oquendo, president of the American Psychiatric Association, said in a statement that the organization was also concerned about changes under the GOP’s proposed law, echoing others’ concerns about its impact on Medicaid. “Nearly one-third of people receiving coverage through Medicaid expansion have mental health or substance use disorders,” she says.
The bill is currently facing criticism from both sides of the aisle, and it’s still unclear how the bill might change before it lands on the President’s desk.