The American Psychological Association (APA) said it has serious concerns regarding the bill to repeal and replace the Affordable Care Act, arguing that it would reduce mental health and substance use coverage for millions of Americans enrolled in Medicaid and contribute to the loss of coverage for millions more individuals.
“Any health care reform legislation considered by Congress should increase, not decrease, the number of Americans with access to affordable health care,” said APA President Antonio E. Puente, PhD. “While we support efforts to strengthen and stabilize our nation’s health care system and extend insurance coverage and protections, we oppose the legislation as introduced in light of the adverse impact it will have on Americans, particularly those with mental health and substance use disorders.”
An estimated 11 million Americans with incomes below 138 percent of the federal poverty level currently have coverage for mental health and substance use disorders, provided at parity with coverage for general medical services through Medicaid expansion plans. The current bill, called the American Health Care Act, would remove the requirement that Medicaid benchmark plans cover essential health benefits, which include mental health, substance use and behavioral health services.
“Removing this requirement would cause the loss of coverage for these life-saving treatments to millions of Americans and challenge the health of our nation,” Puente said.
APA and its affiliated APA Practice Organization also criticized the bill’s prohibition of funding for providers that primarily offer reproductive health services under Medicaid. This limitation would effectively cut off access to care for many low-income women as well as sexual and gender minorities, many of whom would not have access to health care if they could not access these service providers.
“Additionally, the American Health Care Act would significantly reduce funding for Medicaid by restructuring the program into a series of steadily dwindling per-capita capped payments to states,” Puente added. “Although no estimates are available from the Congressional Budget Office, independent analysis by health care economists project that the American Health Care Act will reduce payments to states by $370 billion over the next decade. These reductions will accelerate in later years, resulting in negative impacts on the economy. These steep cuts will force states to either reduce enrollment and/or benefits, and would harm those most at risk of having a mental health or substance use disorder.”
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