(2-22-17  The National Alliance on Mental Illness has asked its members to contact their U.S. Representatives and Senators and ask them to vote against repealing the Affordable Care Act on Thursday.

In a message sent to its members and leaders, the national office wrote:

One in five Americans experiences a mental health condition, but only half get needed treatment. Coverage for mental health care helps people get treatment when they need it, helping them to stay in school, on the job and in recovery.

But the American Health Care Act (AHCA) would reduce funding for health coverage–from insurance plans to Medicaid–and put mental health care at risk. It caps Medicaid funding, which will lead to deep cuts and jeopardize mental health services.

Tell your U.S. Representative this is unacceptable.

The request by the nation’s largest grassroots mental health organization includes a form that can be easily filled out. I’ve posted NAMI’s rationale at the bottom of this blog.

The clamor in the media about whether President Trump can corral enough Republican votes to secure passage of his bill reminds me of when I was a young reporter on Capitol Hill and the Carter administration was rallying support for its Panama Canal treaty that many saw as the U.S. giving away the canal that it had built.

Just like now, there were many representatives saying they were not certain how they would vote. What I later learned is that most of them actually had made up their minds, they simply knew that if they voted with the President, many of them would risk being booted out of office because they came from districts that didn’t support Carter’s treaty.

Consequently, they were waiting to see what the White House would be willing to give them in the way of pork federal projects in return for a vote.

I suspect some of the jockeying going on is about trade offs. It is how Washington works.

One difference in the Republican bill is that it will give control on mental health dollars back to the states through community block grants. This was the same rationale that was used when President Ronald Reagan pushed through the Omnibus Budget Reconciliation Act that repealed Carter’s community health legislation and established block grants for the states, ending the federal government’s role at the time in providing services to the mentally ill.  Federal mental-health spending decreased by 30 percent.

Just another memory from the past.

Regardless of how you feel, you should let your House member know. Ask how the Republican bill will help or harm persons with mental disorders, then you can make an educated recommendation. Remember, your elected officials work for you.

Here is why NAMI says it is opposing the AHCA (Trump bill.)

Individual and Small Group Health Insurance

  • Current federal help to buy health insurance would be reduced, leaving millions of people, including people with mental illness, unable to afford mental health care.

Traditional Medicaid

  • Traditional Medicaid would be converted to a “per capita cap” system, which means states would get a fixed amount of federal funding per person. Instead of flexibility, this would lead to deep cuts over time and jeopardize mental health services.
  • Federal Medicaid funding would be frozen at current levels, adjusted for inflation. Funding for mental health and substance use services is already inadequate and could not be improved without cutting other needed health care.

Medicaid Expansion

  • Nearly 1 out of 3 people covered by Medicaid expansion live with a mental health or substance use condition. This bill would end new enrollment in 2020, leaving people with mental health and substance use conditions without the Medicaid services they need to stay in school, on the job and in recovery.
  • Medicaid expansion plans would no longer have to cover mental health and substance use care, abandoning Congress’ commitment to mental health and substance use coverage.
  • People covered by Medicaid expansion before 2020 would be dropped from their plan if they have a lapse of coverage of more than a month. For people with mental illness, this is a high price to pay for forgetting to pay a premium while someone is in the hospital or experiencing severe symptoms.

Congress shouldn’t put millions of Americans with mental illness at risk. Cutting corners in health coverage will keep people from getting the treatment they need and will push people with mental illness into costly emergency rooms, hospitals and jails.

Investing early in affordable, quality mental health care promotes recovery and saves taxpayer dollars in the long term by avoiding disability, criminal justice involvement and frequent hospital stays.


About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.