National Council for Mental Wellbeing

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March 15, 2018


Aaron Cohen
(301) 633-6773

WASHINGTON, D.C. – The American Health Care Act (AHCA) as written would devastate Americans’ mental health and addiction coverage and care. The National Council for Mental Wellbeing, the unifying voice of America’s mental health and addictions treatment organizations, is opposed to the bill as written.

Medicaid is the single largest payer of mental health and addiction treatment services in the country, paying 25 percent of all mental health and 20 percent of all addiction care. The Congressional Budget Office (CBO) scores released yesterday project that in the next 10 years, 14 million people would lose Medicaid coverage under the proposed AHCA – this is more than the number who gained Medicaid coverage under the Affordable Care Act. Put simply, if this bill passes, 14 million people who rely on Medicaid will not get the care they need, including millions for whom Medicaid provides treatment for substance use disorders or mental illnesses. Many will instead end up homeless, in jail or dead.

The health bill reduces taxes on the wealthiest Americans, which will cost the federal government hundreds of billions of dollars. It is unconscionable that this is being offset by cutting $880 billion from Medicaid beneficiaries, the poorest, sickest, neediest Americans. CBO reports the bulk of the “savings” will come from lower Medicaid enrollment – meaning that these tax cuts are only possible because 14 million people will go without care. We in the behavioral health field stand united with other health care provider organizations to protect Medicaid, and reject the drastic cuts to Medicaid.

Medicaid has emerged as states’ primary tool to tackle the opioid epidemic. Any proposals that roll back Medicaid coverage or shift costs to states will have a significant impact on this vulnerable population.

We cannot afford to go backward. This affects real people. Like Katie, who started with pain pills in high school and was soon up to eight oxycodone a day. Ten years later, thanks to Medicaid, she is getting real help, and working on her college degree in biology. Medicaid helps pay for her treatment. What happens if that help is no longer available? “My dream is to have a normal life. But without Medicaid, I don’t know what would happen to me. I know I could start using again.”

The problem is getting worse. Maryland has declared a state of emergency, as opioid deaths increased 50 percent in the last year. In Alaska, the number of heroin-associated deaths more than tripled from 2008 to 2013. New Mexico leads the nation, by far, in deaths because of alcohol. Vermont Governor Phil Scott (R) put it in these stark terms: “This battle continues to be one of the great challenges of our time. How we react, and how we choose to respond to it, will be remembered long after our service has ended.”

Now is not the time to provide less support to those in need. Addictions touched President Trump’s family – now other families need his help. The Congress that invested in the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act can and must do better for people living with mental illnesses and addiction.

Medicaid is not a partisan issue – it’s a human issue. Cutting it will devastate real people.


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