National/State BH Groups Express Strong Opposition to the AHCA

NYAPRS Note: NYAPRS joined over 400 national, state and local behavioral health advocacy and service organizations yesterday to express strong opposition to the American Health Care Act, the GOP’s proposed replacement to the Affordable Care Act.
The groups represent consumers, families, providers, health care and social service professionals, advocates and allied organizations from across the country and shared their great concerns “that rolling back the Medicaid expansion, sunsetting the EHB (essential health benefit) requirements for Medicaid expansion plans, and capping federal support for Medicaid beneficiaries will reduce coverage for and access to addiction and mental health treatment services, changes that will be particularly painful in the midst of the ongoing opioid overdose and suicide epidemics.”
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March 21, 2017


Dear Speaker Ryan and Leader Pelosi,

The undersigned organizations are writing to share our views on the American Health Care Act (AHCA) as reported by the Ways and Means and Energy and Commerce committees. We are very concerned that the AHCA’s proposed changes to our health care system will result in reductions in health care coverage, particularly for vulnerable populations including those suffering from addiction and mental illness, and we cannot support the bill in its current form.

We collectively represent consumers, families, providers, health care and social service professionals, advocates and allied organizations who are committed to meaningful and comprehensive policies to reduce the toll of substance use disorders and mental illness through prevention, treatment and recovery support services.

More than 20 million Americans currently have health care coverage due to the Affordable Care Act (ACA), including millions of Americans with addiction and mental illness. This coverage is a critical lifeline for these individuals, many of whom were unable to access effective treatment before the ACA’s expansion of Medicaid eligibility to low-income adults, and its requirement that Medicaid expansion plans and plans sold in the individual and small group markets provide essential health benefits (EHB) including addiction and mental health treatment services at parity with medical and surgical services.

In the face of the opioid overdose and suicide epidemics, equitable access to a full continuum of mental health and substance use disorder treatment services, including medications to treat addiction and mental illness, must be an essential component of health care coverage. It is also critical that addiction and mental illness be covered on par with other medical conditions consistent with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).

The Affordable Care Act (ACA) extended the applicability of MHPAEA to the small and individual group market as well as Medicaid expansion plans, which are currently required to offer addiction and mental health services at parity with medical and surgical services. As authors writing in the New England Journal of Medicine recently noted, “Repeal of the ACA would dismantle these protections and turn the clock back to a time when most Americans were subject to restrictive and inequitable limits on coverage for medication treatment and other supplementary treatments for opioid use disorder.”

We are concerned that rolling back the Medicaid expansion, sunsetting the EHB requirements for Medicaid expansion plans, and capping federal support for Medicaid beneficiaries will reduce coverage for and access to addiction and mental health treatment services, changes that will be particularly painful in the midst of the ongoing opioid overdose and suicide epidemics. Moreover, while the AHCA retains the EHB requirements for private plans, it repeals the ACA’s actuarial value requirements for those plans. We are concerned that this could result in insurers offering mental health and addiction treatment benefits in name only due to higher costs and/or less robust benefits.

The Medicaid expansion in particular has led to significant increases in coverage and treatment access for persons with addiction and mental illness. In states that expanded Medicaid, the share of people with addiction or mental illness who were hospitalized but uninsured fell from about 20 percent in 2013 to 5 percent by mid-2015, and Medicaid expansion has been associated with an 18.3 percent reduction in unmet need for addiction treatment services among low-income adults.

Rolling back the Medicaid expansion and fundamentally changing Medicaid’s financing structure to cap spending on health care services will certainly reduce access to evidence-based treatments and reverse much or all progress made on the opioid crisis last year. Moreover, the loss of Medicaid-covered mental and substance use disorder services for adults would result in more family disruption and out-of-home placements for children, significant trauma which has its own long-term health effects and a further burden on a child welfare system that is struggling to meet the current demand for foster home capacity.

The ACA’s Medicaid expansion, EHB requirements for addiction and mental illness treatment coverage, and extension of parity protections to the individual and small group market have surely reduced the burden of the opioid misuse and overdose and suicide epidemics and saved lives. As you consider this legislation, we ask that you ensure addiction and mental health treatment benefits continue to be available to Americans enrolled in the individual, small and large group markets as well as Medicaid plans and that these benefits are compliant with the Mental Health Parity and Addiction Equity Act.

Finally, throughout this process, we implore you to keep in mind how your decisions will affect the millions of Americans suffering from addiction and mental illness who may lose their health care coverage entirely or see reductions in benefits that impede access to needed treatment.

Sincerely,

Acadia Healthcare

Adcare Educational Institute

Addiction Education Society

Addiction Haven


Addiction Resource Council

Addiction Services Council

Addiction Policy Forum

Addiction Treatment Center of New England

Addictions Connections Resource

Advocates for Recovery Colorado

Advocates, Inc.

Alabama Society of Addiction Medicine

Alano Club of Portland

Alcohol & Addictions Resource Center

Alcohol/Drug Council of North Carolina

Alternatives Unlimited, Inc.

Amesbury Psychological Center, Inc.

American Correctional Association

American Federation of State, County and Municipal, Employees (AFSCME)

American Academy of Addiction Psychiatry

American Academy of Pediatrics

American Association for Marriage and Family Therapy

American Association for the Treatment of Opioid Dependence (AATOD)

American Association of Child & Adolescent Psychiatry

American Association on Health and Disability

American Dance Therapy Association

American Foundation for Suicide Prevention

American Medical Student Association

American Nurses Association

American Public Health Association

American Psychiatric Association

American Psychological Association

American Society of Addiction Medicine

A New PATH

Anxiety and Depression Association of America

Arc of South Norfolk, The

Arise & Flourish

Arizona’s Children Association

Arizona Council of Human Service Providers

Arizona Society of Addiction Medicine

Arkansas Society of Addiction Medicine

Association for Ambulatory Behavioral Healthcare

Association for Behavioral Healthcare of Massachusetts

Association for Community Affiliated Plans

Association for Community Human Service Agencies

Association of Asian Pacific Community Health Organizations (AAPCHO)

Association of Flight Attendants – CWA, AFL-CIO

Association of Persons Affected by Addiction (APAA)

Association of Recovery Schools

Association of Recovery Community Organizations

Association of Women’s Health, Obstetric and Neonatal Nurses

A Stepping Stone to Success

Atlantic Prevention Resources, Inc.

Avanti Wellness

BAMSI

Bangor Area Recovery Network, Inc.

Bay Cove Human Services

Bay State Community Services, Inc.

Bazelon Center for Mental Health Law

Behavioral Health Network, Inc.

Better Life in Recovery

Bill Wilson Center

Boston Alcohol and Substance Abuse Programs, Inc.

Boston Healthcare for the Homeless

Boston Public Health Commission

BreakingTheCycles

Bridge of Central Massachusetts, Inc.,

The Bridgewell

Brien Center for Mental Health and Substance Abuse Services,

The Brookline Community Mental Health Center

Bullhook Community Health Center, Inc.

Burke Recovery

California Consortium of Addiction Programs & Professionals

California Council of Community Behavioral Health Agencies

California Society of Addiction Medicine

Cambridge Health Alliance

Camelot Care Centers, Inc.

Cape Cod Healthcare Centers for Behavioral Health

Capital Area Project Vox

Casa Esperanza

Casa Pacifica Centers for Children and Families

Catholic Charities Family Counseling and Guidance Center

Catholic Family Center

Center for Human Development

Center for Open Recovery

Center for Recovery and Wellness Resources

Chautauqua Alcoholism and Substance Abuse Council

Chicago Recovering Communities Coalition (CRCC)

Child & Family Services, Inc.

Child and Family Services of New Hampshire

Children’s Friend, Inc.

Children’s Home Society of Washington

Children’s Law Center

Children’s Services of Roxbury

CleanSlate

Clergy for a New Drug Policy

Clinical and Support Options, Inc.

Clinical Social Work Association

Coalition of Addiction Students and Professionals Pursuing Advocacy (CASPPA)

Colorado Society of Addiction Medicine

Communities for Recovery

Community Counseling of Bristol County, Inc.

Community-Minded Enterprises

Community Oriented Correctional Health Services (COCHS)

Community Services Institute

Community Solutions

Community Substance Abuse Centers

Connecticut Community for Addiction Recovery (CCAR)

Connecticut Society of Addiction Medicine

Counselors Obediently Preventing Substance Abuse (COPS)

Cutchins Programs for Children and Families

DarJune Recovery Support Services & Café

Dash for Recovery

Davis Direction Foundation - The Zone

DC Fights Back

DC Recovery Community Alliance

Delphi Behavioral Health Group/MHD

Desert Eagle Addiction Recovery

Detroit Recovery Project, Inc.

Dimock Community Health Center

Disability Rights Pennsylvania

Doctors for Recovery

Dorchester Recovery Initiative

Drug and Alcohol Service Providers Organization of Pennsylvania (DASPOP)

Drug Prevention Resources

East Bay Agency for Children

Easy Does It, Inc.

Eating Disorders Coalition

Edinburg Center, The

Eliot Community Human Services

El Paso Alliance

Engaged Recovery Community Services

Faces and Voices of Recovery

Facing Addiction

Family Focused Treatment Association

Family Service Association

Family Service of Greater Boston

FAVOR Greenville

FAVOR Low Country

FAVOR Mississippi Recovery Advocacy Project

FAVOR Pee Dee

FAVOR Tri-County

FED UP! Coalition

Fellowship Foundation Recovery Community Organization

Fenway Health

FHR

Florida Society of Addiction Medicine

Floridians for Recovery

Foundation for Recovery

Friends of Recovery - New York

FSA – Family Service Agency

Futures of Palm Beach

G III Associates

GAAMHA

Gandara Center

Georgia Council on Substance Abuse

Georgia Society of Addiction Medicine

Gosnold on Cape Cod

Granite Pathways

Greater Macomb Project Vox

Greater Philadelphia Association for Recovery Education

Great South Bay Coalition

Greater Cincinnati Recovery Resource Collaborative (GCRRC)

Griffin Recovery Enterprises

Harm Reduction Coalition

High Point Treatment Center

Hillview Mental Health Center, Inc.

Home for Little Wanderers, The

HOPE for New Hampshire Recovery

Hope House Addiction Services

Horizon Health Services

IC&RC

Illinois Association for Behavioral Health

Indiana Society of Addiction Medicine

International Nurses Society on Addictions

Institute for Health and Recovery

Iowa Association of Community Providers

Italian Home for Children, Inc.

Jackson Area Recovery Community

Jewish Family and Children’s Services (JF&CS)

Joint Coalition on Health

Jordan's Hope for Recovery

Judge Baker Children’s Center

Juneau Recovery Community

Justice Resource Institute (JRI)

Kentucky Society of Addiction Medicine

KEY Program, Inc., The

Kyes 2 a 2nd Chance

Lahey Health Behavioral Services

Lakeshore Foundation

Latah Recovery Center

Legal Action Center

Lifehouse Recovery Connection

Lifeline Connections

Long Island Council on Alcoholism and Drug Dependence, Inc.

Long Island Recovery Association (LIRA)

Lost Dreams Awaken Center, Inc.

Lotus Peer Recovery/SoberKerrville

Lowell Community Health Center, Inc.

Lowell House, Inc.

LUK, Inc.

Madison County Council on Alcoholism & Substance Abuse

Magnolia Addiction Support

Maine Alliance for Addiction Recovery

Mariah’s Mission Fund of the Mid-Shor Community Foundation

Mark Garwood SHARE Foundation

Martha’s Vineyard Community Services

Maryland-DC Society of Addiction Medicine

Maryland House Detox

Maryland Recovery Organization Connecting Communities (M-ROCC)

Massachusetts Organization for Addiction Recovery (MOAR)

Massachusetts Society of Addiction Medicine

McShin Foundation

Mental Health Association

Message Carriers of Pennsylvania, Inc.

MHA of Greater Lowell

Michigan's Children

Michigan Recovery Voices

Michigan Society of Addiction Medicine

Middlesex Human Service Agency, Inc

Mid-Michigan Recovery Services, Inc.

Mi-HOPE - Michigan Heroin & Opiate Prevention and Education

Minnesota Association of Community Mental Health Programs (MACMHP)

Minnesota Recovery Connection

Minnesota Society of Addiction Medicine

Missouri Recovery Network

MOBER

Mountain View Prevention Services, Inc.

NAADAC – the Association for Addiction Professionals

National Alliance for Medication-Assisted Recovery (NAMA)

National Alliance on Mental Illness

National Alliance to Advance Adolescent Health

National Alliance to End Homelessness

National Association for Rural Mental Health

National Association of Addiction Treatment Providers

National Association of Clinical Nurse Specialists

National Association of Pediatric Nurse Practitioners

National Association of State Mental Health Program Directors (NASMHPD)

National Association for Children’s Behavioral Health

National Association for Rural Mental Health

National Association of Drug Court Professionals

National Association of Social Workers (NASW)

National Association of County Behavioral Health and Developmental Disability Directors

National Council for Behavioral Health

National Center on Addiction and Substance Abuse

National Council on Alcoholism and Drug Dependence

National Council on Alcoholism and Drug Dependence of E. San Gabriel & Pomona Valleys

National Council on Alcoholism and Drug Dependence--Greater Phoenix

National Council on Alcoholism and Drug Dependence – Maryland

National Council on Alcoholism and Drug Dependence – San Diego

National Council on Alcoholism and Drug Dependence of the San Fernando Valley

National Council on Alcoholism and Drug Abuse-St. Louis Area

National Disability Rights Network

National Federation of Families for Children’s Mental Health

National Health Care for the Homeless Council

National Safety Council

Navigate Recovery Gwinnett

Nevada Society of Addiction Medicine

New Jersey Association of Mental Health and Addiction Agencies, Inc.

New Jersey Society of Addiction Medicine

New Life Counseling & Wellness Center, Inc.

New Mexico Society of Addiction Medicine

New York Association of Psychiatric Rehabilitation Services

New York Society of Addiction Medicine

New York State Council for Behavioral Health

NFI Massachusetts, Inc.

NMSAS Recovery Center

No Health without Mental Health

North Charles, Inc.

North Cottage Program, Inc.

Northeast Center for Youth and Families, The

Northern New England Society of Addiction Medicine

Northern Ohio Recovery Association (NORA)

Northwest Indian Treatment Center

North Suffolk Mental Health Association, Inc.

Northern Rivers Family Services

North Carolina Society of Addiction Medicine (NCSAM)

O’Brien House

Ohio Society of Addiction Medicine (OHSAM)

Oklahoma Citizen Advocates for Recovery & Treatment Association (OCARTA)

Old Colony YMCA

Open Doorway of Cape Cod

Oregon Recovery High School

Oregon Society of Addiction Medicine

Overcoming Addiction Radio

Partnership for Drug-Free Kids

Partners in Prevention/National Council on Alcoholism and Drug Dependence of Hudson County, Inc.

P.E.E.R Wellness Center, Inc.

PEER360 Recovery Alliance

Pennsylvania Recovery Organization - Achieving Community Together - (PRO-ACT)

Pennsylvania Recovery Organizations Alliance (PRO-A)

Pennsylvania Society of Addiction Medicine

People Advocating Recovery - PAR

Phoenix Houses of New England

Phoenix Multisport Boston

Pine Street Inn

Pivot, Alcohol and Substance Abuse Council of Jefferson County, Inc.

PLR Athens

Pretrial Justice Institute

Prevention Network OCAA

Putnam Family & Community Services, Inc.

RASE Project

REAL- Michigan (Recovery, Education, Advocacy & Leadership)

Recover Project/Western MA Training

Recovery Allies Of West Michigan

RecoveryATX

Recovery Café Seattle

Recovery Community Foundation of Forsyth

Recovery Communities of North Carolina

Recovery Community Of Durham

Recovery Consultants of Atlanta

Recovery Data Solutions

Recovery - Friendly Taos County

Recovery Idaho, Inc.

Recovery is Happening

RecoveryNC (Governors Institute on Substance Abuse)

Recovery Point at HER Place

Recovery Point of Bluefield

Recovery Point of Charleston

Recovery Point of Huntington

Recovery Point of Parkersburg

Recovery Point of West Virginia

Recover Wyoming

reGROUP

Rhode Island Communities for Addiction Recovery Efforts (RICAREs)

Riverside Community Care

Robby’s Voice

ROCovery Fitness

Rockland Council on Alcoholism and Other Drug Dependence, Inc.

Sandusky Artisans Recovery Community Center

Sandy Hook Promise

Serenity Sistas

ServiceNet

SMART Recovery

Solano Recovery Project

Solutions Recovery, Inc.

Sonoran Prevention Works

South Arkansas Regional Health Center, Inc

Sound Community Services, Inc.

South Middlesex Opportunity Council, Inc. (SMOC)

South Bay Community Services

South Carolina Society of Addiction Medicine

South Central Human Relations Center

South End Community Health Center

South Shore Mental Health

Spectrum Health Systems, Inc.

SpiritWorks Foundation

Springfield Recovery Community Center

Springs Recovery Connection

SSTAR

STEP Industries

Steppingstone, Incorporated

Student Assistance Services Corp

Substance Use and Mental Health Leadership Council of Rhode Island

Technical Assistance Collaborative, Inc.

Tennessee Society of Addiction Medicine

Texas Society of Addiction Medicine

The Addict’s Parents United (TAP United)

The Alliance

The Bridge Foundation

The Bridge Way School

The Campaign for Trauma-Informed Policy and Practice

The Chris Atwood Foundation

The Council on Alcohol and Drug Abuse

The Council on Alcohol & Drug Abuse for Greater New Orleans

The DOOR - DeKalb Open Opportunity for Recovery

The Global Alliance for Behavioral Health and Social Justice

The Kennedy Forum

The Ohana Center

The Recovery Channel

The Rest of Your Life

The Trevor Project

The Village Family Services

The Village Project, Inc.

Tia Hart Recovery Community Program

T.O.R.C.H Inc.

Toward Independent Living and Learning, TILL, Inc.

Treatment Communities of America

Trilogy Recovery Community

Two Guys and a Girl

UMass Memorial Community Healthlink, Inc.

United Methodist Church - General Board of Church and Society

Utah Support Advocates for Recovery Awareness (USARA)

Veterans Inc.

Vermont Council of Developmental and Mental Health Services

Vermont Recovery Network

Victory Programs, Inc.

Vinfen

Virginia Association of Recovery Residences

Voice for Adoption

Voices of Hope for Cecil County

Voices of Recovery San Mateo County

Volunteers of America of Massachusetts, Inc.

WAI-IAM, Inc. and RISE Recovery Community

Walker, Inc.

Washtenaw Recovery Advocacy Project (WRAP)

Washington Federation of State Employees

Washington Recovery Alliance

Washington Society of Addiction Medicine

Watershed Treatment Programs

Wayside Youth & Family Support Network

WEConnect

Wellspring Recovery Services

West Virginia Society of Addiction Medicine Page 10 of 10

WholeLife Recovery Community/ Arizona Recovery Coalition

Wisconsin Recovery Community Organization (WIRCO)

Wisconsin Society of Addiction Medicine

Wisconsin Voices for Recovery

Wyoming County CARES

Yoga of Recovery

Young Invincibles

Young People in Recovery

Young People in Recovery – Los Angeles

Youth Opportunities Upheld, Inc.

Youth Villages