In a letter yesterday to Congressional leaders, APA President Maria A. Oquendo, M.D., Ph.D., and APA CEO and Medical Director Saul Levin, M.D., M.P.A., outlined APA's objections to the bill, which the Congressional Budget Office has estimated would eliminate coverage for some 24 million Americans.
Among APA's chief concerns are the proposed changes to Medicaid and private insurance that would disproportionately affect those with serious mental illness. “APA is not supportive of the changes to Medicaid and Medicaid financing contained within AHCA,” Oquendo and Levin wrote. “Unraveling the expansion of Medicaid coverage [under the ACA] threatens the 1.3 million Americans with serious mental illness and the 2.8 million Americans with substance use disorders who gained coverage for the first time under the expansion. Furthermore, the Medicaid financing provisions contained within the AHCA will eliminate the current requirement that states cover mental health services and reduce overall Medicaid funding by $880 million, or 25 percent, over 10 years.”
Additionally, Oquendo and Levin said APA is also not supportive of certain reforms to private insurance coverage that potentially stand to affect individuals with mental illness and substance use disorders disproportionately. “These include refundable tax credits that are on average significantly less generous than the current subsidies available for premium support and hefty premium surcharges for failing to maintain continuous coverage,” they wrote.
APA is also concerned about proposals to eliminate "essential health benefits" that were mandated for coverage under the ACA. Among these 10 essential benefits is coverage of treatment of mental illness and substance use disorders and include such services as depression screening for adults and adolescents, behavioral assessments for children, alcohol use screening and counseling for adults, alcohol and drug use assessments for adolescents, tobacco use screening for adults, and cessation interventions for tobacco users.
In a press statement, Oquendo said, “We are willing to work with members of both parties in Congress so that more Americans have access to high-quality care. Unfortunately, we cannot support the AHCA bill because it is not a solution.”
APA members can access the phone number of their House representative at APA's Action Center.