What The Senate Health Care Bill Could Mean For People With Mental IllnessSpoiler alert: It’s not good.
By Lindsay Holmes Huffington Post June 22, 2017
The draft of the Senate health care reform bill, called the Better Care Reconciliation Act, released Thursday prompted new anxiety over what the eventual bill could mean for those living with mental illness.
The short answer: Less coverage for more money.
The bill is largely similar to the one passed by House Republicans in May. Nearly 23 million Americans were estimated to lose health coverage under the House bill, known as the American Health Care Act, according to the Congressional Budget Office. Lawmakers hope to have the CBO’s analysis for the Senate’s version by early next week.
The Senate’s bill most striking measure would slash Medicaid by almost a trillion dollars through cutting back on federal funding over a decade. That will affect all aspects of health coverage(for example, Medicaid covers 40 percent of all children’s basic health care). But it will also have a major impact on mental health: Medicaid is the single largest payer of mental health services in the country.
This could potentially leave millions of Americans without coverage that could help them get the care they need, like therapy, for mental health issues.
The Senate bill does protect those with pre-existing conditions, including mental illness, more than the House version. It does this by keeping a provision, known as the community rating,that prevents health insurers from charging those with pre-existing conditions more.
However, the Senate’s plan may still propose giving states the power to waive what’s known as essential health benefits. This would allow insurance companies in those areas to exclude certain benefits from their coverage, like mental health or substance use disorder services.
An analysis published Tuesday, before the draft was released, by the Center for American Progress said prices could go up for mental health and substance use disorder treatment because of these waivers.
Less comprehensive insurance plans could drive up costs of treatments for conditions like mental illness by essentially forcing people to buy added coverage for treatment for their behavioral health condition. Or, it may push them to select a more expensive plan with broader coverage in the first place. As CAP points out, expenses people could incur by the year 2026are not small:
In states that waived requirements for substance use disorder and mental health benefits, coverage for drug dependence treatment would cost an extra $20,450, and coverage for depression would cost an extra $8,490.
The Senate’s draft legislation could be changed before there’s a vote on it. Still, the chamber’s GOP leaders are pushing to bring it to the floor as early as next week.
Mental health protection is something the country supports:A recent poll found that the majority of Americans ― regardless of political party ― think mental health care should be covered by insurance.
Mental health organizations have been expressing concern about how the Republican effort to repeal and replace Obamacare could affect people living with mental illness. American Psychiatric Association officials noted that they were not consulted on the House version or the Senate’s draft legislation.
Dr. Saul Levin, the association’s CEO and medical director, on Thursday blasted the Senate proposal as “represents a significant move in the wrong direction, resulting in fewer people having access to insurance, fewer patient protections, and less coverage for essential behavioral health care.”
He urged the Senate “to reject this harmful legislation and start again on a health care bill that puts patients first.”
About one in five American adults will be affected by a mental illness annually. Not having access to proper treatment for those disorders can be catastrophic: Data shows untreated mental health issues is one of the most frequent causes of suicide ― major public health problem that’s been steadily on the rise over the last 15 years.
Research shows medical care, through therapy, medication or both, is effective in helping to curb mental health issues, but that access to such care is slowly dwindling. That’s thanks in part to issues with insurance. A study published in April by NYU’s Langone Medical Center found that 10.5 percent of people in 2014 experienced delays in getting treatment due to insufficient mental health coverage, a small rise from the last time data was gathered in 2006.
Mental health advocates have vowed to fight against any legislation that threatens those living with mental illness. This includes pushing for other laws that help those individuals and promoting programs that help them get treated,said Linda Rosenberg,president and CEO of the National Council for Behavioral Health.
“Mental illness is an illness like any other,” Rosenberg previously told HuffPost.“People recover and they can live full and productive lives with effective treatment. We just have to be sure that treatment is still available in every community, just like we do for cancer and heart disease.”
Health Care Bill Could Boot People With Addiction Out of Treatment
By Alexandra Sifferlin Time Jun 23, 2017
The health care bill released by Senate Republicans on Thursday is stoking outrage among mental health and addiction groups for its proposed steep cuts to Medicaid, the government’s largest health insurance program. Medicaid is the single largest payer for mental health services in the United States and provides coverage for millions of Americans with mental health or substance abuse disorders.
The proposed change is especially painful for these organizations because they saw an expansion of mental health coverage under the Affordable Care Act. After it was enacted, an estimated 2.8 million Americans with substance use disorders and 1.3 million with serious mental illness gained health insurance coverage for the first time under Medicaid expansion. In some states, Medicaid programs cover more than 40% of prescriptions of buprenorphine, a drug that treats opioid addiction.
The new bill would cut billions from the Medicaid budget and phase out Medicaid expansion. It also could allow states to apply for waivers to remove the requirement that health plans cover some essential health benefits, like mental health and addiction services.
These services can include counseling, detox, in-patient treatments and medications for opioid addiction.
Insurers may not continue to cover these health services if they are no longer required by states to do so, suggests a June report from the Kaiser Family Foundation. The report, which looked at over 8,000 non-group plans, showed that before the Affordable Care Act, 45% of plans did not cover out or inpatient substance use disorder services and 38% did not cover out of inpatient mental health and behavioral health services, likely due to the expense.
“It’s so frustrating to see the Senate bill proposed as is,” says Dr. Leana Wen, commissioner of health for the city of Baltimore; she adds that o ne out of three people in Maryland receiving treatment for substance use disorder are on Medicaid . “There is no margin of error for people getting addiction treatment,” she says. “If people getting treatment were to stop, their alternative could be to overdose and die.”
The American Psychiatric Association (APA), which includes more than 37,000 physician members, also called the bill “deeply flawed” on Thursday. The organization, among several other prominent health groups, says it was not consulted during the formation of the new bill. “The Senate proposal represents a significant move in the wrong direction, resulting in fewer people having access to insurance, fewer patient protections and less coverage for essential behavioral health care,” said Dr. Saul Levin, CEO and medical director of the APA, in a statement. “We urge the Senate to reject this harmful legislation and start again on a health care bill that puts patients first.”
But the amount in the fund is substantially lower than some GOP lawmakers were calling for, STATreports. Senator Rob Portman of Ohio and Senator Shelley Moore Capito of West Virgina, representing two states at the center of the ongoing opioid crisis, had previously called for $45 billion over the course of a decade for fighting the opioid crisis.
spent an estimated $1 billion a year