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Michael Petruzzelli

, National Council for Mental Wellbeing

Health Reform Update: New Amendment Has Congress Moving Forward on Repeal and Replace

April 27, 2017 | ACA | Medicaid | Comments
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A new amendment to the American Health Care Act (AHCA) would give states greater authority to roll back key provisions of the Affordable Care Act (ACA), including the essential health benefits and protections for those with pre-existing conditions. This amendment could be particularly harmful to those with mental illness and addiction as it would create greater barriers to accessing care and having these important services offered at parity with primary care services. The National Council remains opposed to this legislation and is calling on advocates to speak up today to urge legislators to vote “No” on AHCA.

The AHCA amendment, introduced late Tuesday night, was written primarily by moderate Republican Rep. Tom MacArthur (R-NJ) and leaders of the more conservative House Freedom Caucus. While the House Freedom Caucus officially endorsed the bill on Wednesday, the more moderate Tuesday Group has offered no such praise or support. In fact, several moderate Republicans have already come out against the amendment as it does not alter the underlying concerns they had with the bill last month. House leaders are currently counting votes in the hopes of passing the bill by week’s end.

The amendment would allow states to submit a waiver application to exempt themselves from the provisions of the ACA that require insurers to offer a minimum set of essential benefits and that bar higher premium payments for people with pre-existing health conditions and for older Americans. To receive a waiver, states must demonstrate that they have established a high-risk pool. The amendment stipulates that waivers must be approved by default so long as they meet at least one of the following criteria:

  • Reduces average premiums for health insurance coverage;
  • Increases enrollment in health insurance coverage;
  • Stabilizes the market for health insurance coverage;
  • Stabilizes premiums for individuals with pre-existing conditions; or
  • Increases the choice of health plans in the states.

For mental health and addiction advocates it is important to note that these are particularly low thresholds, as reducing premium rates can be done by offering fewer benefits or dropping more expensive coverage protections like mental health and addiction treatment services.


National Council advocates have been the backbone of our Unite4BH campaign over the last several months. With letters, phone calls, meetings and action alerts, thousands of dedicated constituents have spoken up and ensured that their voices are heard on Capitol Hill. We thank you all for your tremendous hard work and advocacy and ask that you join us again to oppose this bill and protect millions of Americans’ mental health and addiction coverage.

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