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Michael Petruzzelli

, National Council for Mental Wellbeing

Latest Changes to Health Care Bill Would Hurt Medicaid, Behavioral Health

March 23, 2017 | ACA | Medicaid | Comments
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Conversations continued this week on Capitol Hill as congressional leaders and White House officials worked to solidify support for the American Health Care Act. On Monday evening, House Republicans released large scale amendments that include more restrictions on Medicaid expansion as well as block grant and work requirement options for state Medicaid programs. As of this writing, the House has yet to set a timeline to consider and vote on the measure.



Among the many proposed changes to the American Health Care Act this week, the following are of most importance to National Council members:

  • Medicaid Expansion – Prevents states that have not expanded Medicaid under the Affordable Care Act from doing so at the enhanced match rate. Any non-expansion state that seeks to expand Medicaid in the future would receive its regular Medicaid match rate to cover low-income adults up to 133 percent of the Federal Poverty Level.
  • Medicaid Block Grant Option – Beginning in 2020, the bill allows states to opt to receive a block grant for providing health care for their traditional adult and children Medicaid populations. Funding for the block grant would be determined using the same base year calculation for the per capita allotment reforms.
  • Medicaid Work Requirements – Beginning October 1, 2017, states would have the option of instituting a work requirement in Medicaid for able bodied adults as a condition of receiving coverage. This would require many persons with mental illness and addiction to obtain employment before and during treatment. The amendment provides limited additional dollars to fund activities such as job search assistance, community service programs, vocational training, and secondary school attendance.


As the week progressed, conversations and compromises continued between congressional leadership and the more conservative members of the GOP, namely the House Freedom Caucus. On Thursday morning, it was widely reported that Congress was considering removing the essential health benefits requirement from all insurance plans – the AHCA already removes the requirement from Medicaid plans. These benefits include: mental health and SUD services, ambulatory services, emergency services, hospitalization, maternity and new born care, prescription drug coverage, rehabilitation treatments, laboratory services, preventive and wellness care and pediatric services.


As negotiations continue, the National Council is encouraging advocacy from all members on this immensely important issue. Speak up and have your voices heard by your elected officials. Making a difference on takes a few minutes. Click here to get started.