Showing posts with label essential health benefits. Show all posts
Showing posts with label essential health benefits. Show all posts

Friday, September 14, 2018

APA Joins Health Organizations in Lawsuit Against Expansion of Short-Term Health Plans


Joining a coalition of seven mental health and health advocacy groups, APA filed suit today in federal court to invalidate a Trump administration rule on short-term, limited duration health plans.

The coalition argued in its complaint that the final rule, issued last month by three federal agencies, violates the plain-English meaning of “short-term” by allowing the sale of the plans for up to 364 days at a time (up from three months) and “limited duration” by allowing renewals for up to three years (up from 12 months). The plans are sold in the individual market to those without employment-based or government-sponsored insurance.

The coalition also argued that the rule is unlawful because it arbitrarily creates an unauthorized “alternative” to Affordable Care Act (ACA)-compliant plans and violates the ACA by undercutting compliant plans and making them increasingly unaffordable. APA was joined in the lawsuit by the National Alliance on Mental Illness, Mental Health America, National Partnership for Women & Families, Association for Community Affiliated Plans, AIDS United, and Little Lobbyists, according to a news release

Short-term health plans may be less expensive than comprehensive plans, but they are not required to cover “essential health benefits,” such as mental health and substance use disorder services, prescription drugs, hospitalization, emergency services, or maternity care. Similarly, short-term plans are not subject to important consumer safeguards or antidiscrimination rules and can deny coverage for any preexisiting condition; set higher premiums based on age, gender, or health status; retroactively cancel coverage; and deny renewals. Short-term plans may also increase uncompensated care for health care providers, the coalition wrote.

“This rule jeopardizes the insurance coverage of many Americans with complex medical needs that require strong, predictable insurance protection and care,” APA President Altha Stewart, M.D., said in a statement. “Without this coverage, patients with complex medical needs will suffer and often end up in emergency rooms, raising health care costs. We call upon the Administration to drop this rule and enforce the protections of the Affordable Care Act.”

For more information, see the Psychiatric News article “Trump Expands Low-Cost, Short-Term Health Plans.”

Tuesday, November 7, 2017

APA, Responding to Trump on Shooting, Seeks Action on Mental Health


In response to remarks by President Donald Trump this week that the deadly shooting in a Texas church Sunday morning was “a mental health problem,” APA called on the administration and Congress to strengthen and improve access to quality mental health care.

“We are deeply saddened by the senseless violence in a house of worship this weekend,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A., in a statement following the shooting in which 26 people were killed and more than 20 injured when a gunman opened fire at a Baptist church. “We extend our deepest sympathies to the victims, the families, and the community of this tragedy.”

He added that though the president and lawmakers have made comments associating acts of violence with mental illness, research has consistently shown that people with mental illness are not more likely to be perpetrators of violence, but more likely to be victims. In his statement, Levin requested that lawmakers not perpetuate stigma by making premature statements.

“If lawmakers believe it is a mental health issue, why are they not seeking to ensure that more resources are being put into treating those with mental health issues?” Levin asked.

Levin said that for policymakers who are sincere about addressing mental health, a first step is to protect “essential health benefits” in the Affordable Care Act (ACA), which include treatment for mental illness and substance use; those essential health benefits have been targeted in repeated Republican attempts to repeal or replace the ACA. 

“More designated funding should be appropriated to the National Institute of Mental Health, National Institute on Drug Abuse, and National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health to focus on new research to help increase new knowledge on how to prevent, treat, and cure mental illness and substance use disorders,” Levin added. “In addition, APA calls on the administration, the Congress, and state legislators to take needed steps to ensure that access to mental health programs remain intact so people with mental illness and substance use disorders are getting the care they need. The American Psychiatric Association stands ready to help you achieve that goal.”

Wednesday, September 20, 2017

APA Calls for Rejection of Latest Republican Effort to Repeal ACA


APA is urging members to contact their U.S. senators and voice their opposition to the Graham-Cassidy bill—the latest effort by Republicans to repeal and replace the Affordable Care Act. The bill, which was drafted by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) and unveiled last week, appears to be gaining traction in the Senate. 

“This legislation … will lead to millions of Americans losing their health care coverage,” APA CEO and Medical Director Saul Levin, M.D., M.P.A., said Tuesday in a press release. “We are particularly concerned that this bill would make drastic cuts to the Medicaid program and roll back expansion, which has allowed 1.3 million Americans with serious mental illness and 2.8 million Americans with substance use disorder, to gain coverage for the first time. This bill harms our most vulnerable patients.”

Among its many proposals, the bill would allow states to change what qualifies as an essential health benefit, eliminating guaranteed coverage of substance use disorders and mental health treatment services. It would also stop the Affordable Care Act’s Medicaid expansion and cost-sharing subsidies and instead put that money into block grants that states could use to design their own health care systems.

“The APA is ready to work with members of both parties to craft a bipartisan solution that stabilizes the health insurance market and ensures Americans have access to quality, affordable health care,” Levin said.

Last week APA joined with five other medical specialty organizations representing more than 560,000 physicians in a letter to Senate Majority Leader Mitch McConnell and Minority Leader Charles Schumer to oppose the bill. The organizations noted that “a similar proposal was put forth by these two senators in July. Based on our analysis, the revised proposal may actually be worse than the original.”

The Republicans are up against a tight deadline of September 30 to secure the 50 votes needed to pass the measure using the budget reconciliation process. After this date, they would need 60 votes to pass the legislation. The Congressional Budget Office (CBO) on Monday announced that while it will aim to have a preliminary assessment of the Graham-Cassidy bill by early next week, it will not be able to provide point estimates of the bill’s effects on the deficit, health insurance coverage, or premiums for at least several weeks.

APA members are urged to call and email their senators today and register their opposition to the bill through a special portal on the APA website.

(Image: iStock/usschools)

Tuesday, June 27, 2017

Millions to Lose Health Coverage Under Senate Health Bill, CBO Predicts


The Senate Republicans' proposal to repeal and replace the Affordable Care Act (ACA) would increase the number of people without health insurance by 15 million in 2018 and 22 million people by 2026, according to a Congressional Budget Office (CBO) analysis released on Monday. APA responded promptly to the news, renewing its call for the U.S. Senate to reject the bill known as the Better Care Reconciliation Act (BCRA).

“The CBO report highlights in stark terms the negative impact of the Senate proposal. The bill would reverse much progress in recent years by rolling back Medicaid expansion, capping the Medicaid program, and allowing states to waive critical essential health benefits,” APA CEO and Medical Director Saul Levin, M.D., M.P.A., said in a press release. “These changes would be particularly devastating to the millions of Americans in need of mental health and substance use treatment.”

The CBO estimates that by 2026, the BCRA would leave 49 million people uninsured, compared with 28 million who would lack insurance that year under current law. Last month, the CBO estimated that the American Health Care Act (AHCA)—which narrowly passed the U.S. House of Representatives in May—would leave some 14 million more people uninsured in 2018 than under the current law and 23 million more by 2026.

The Senate’s health bill would also cut the federal deficit by $321 billion over the decade, according to the CBO. “The largest savings would come from reductions in outlays for Medicaid—spending on the program would decline in 2026 by 26 percent in comparison with what CBO projects under current law—and from changes to the [ACA’s] subsidies for nongroup health insurance,” according to the analysis.

Earlier Monday, APA released a three-page fact sheet summarizing how Medicaid changes could impact access to and the delivery of mental health and substance use disorder treatment services, among other provisions.

“In less than a year after passing comprehensive mental health reform on a bipartisan, bicameral basis, the Senate is now working to pass harmful legislation that will take a significant step backward on the advances to treat those with mental illness and substance use disorders,” Levin continued. “We strongly urge the Senate to reject this deeply flawed proposal.”

The Senate vote on the bill has been delayed due to insufficient support until after the July 4 recess. However, calls and emails expressing concerns are still important as we need to keep the pressure on key senators over the recess.

Your Voice Counts
APA urges you to contact your senators and speak out against the Senate health care reform bill. APA has created a dedicated tool to make it easy for you to voice your opinion via Facebook, Twitter, or phone.


(Image: iStock/carterdayne)

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