Critics Question Mental Health Protections in GOP Health Bill

Critics Question Mental Health Protections in GOP Health Bill
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Critics are calling into question the ability of Republicans’ health-care reform bill to effectively provide accessible mental health and addiction services to Americans nationwide.

“This is an abomination of a bill,” said Democratic Sen. Chris Murphy, whose 2016 Mental Health Reform Act was signed into law one day before the 2012 Sandy Hook Elementary School shooting. “It doesn’t solve a single problem in our health-care system; it makes existing problems worse, and Republicans know it.”

The American Health Care Act which will be voted on today, the GOP’s second attempt to repeal and replace the Affordable Care Act after a withdrawn initial effort in March.

Notably, the GOP proposal would roll back the Medicaid expansion under the current system and, starting in 2020, would not mandate that states include basic mental health and addiction services in Medicaid plans.

“We’re leaving a lot more decisions to the states, and I trust the states a heck of a lot more than I trust Washington,” said Republican Rep. Steve Chabot in defense of his party’s bill. “Obamacare has failed the American people and we need to make sure we don’t fail them by not repealing it.”

When asked if the AHCA provided mental health-care practitioners with adequate resources to be successful, Republican Rep. Tim Murphy, a former child psychologist, asserted that it “provides them with a lot more resources than they have now … [but] the money is only as useful as the states can use it.”

Hailed by supporters as being lower-cost, more competitive, and more patient-centered than Obamacare, the AHCA promises to grant the insured greater control over their health care choices. Republicans have defended their bill by citing its inclusion of popular Obamacare provisions, such as allowing children to stay on their parent’s coverage until age 26, while pointing out its elimination of less popular ones, including the individual mandate. 

As it pertains to mental health care, Republicans say their measure will cover pre-existing conditions too.

“I think pre-existing conditions are adequately covered,” Chabot said, echoing the assertions of President Trump.

AHCA opponents, however, have expressed concern about the estimated 1.2 million Americans who receive primary mental health and addiction services as a result of the Medicaid expansion. 

“If the administration wants to change the emphasis of mental health care and devote more resources to the severely mentally ill,” said the American Enterprise Institute’s Dr. Sally Satel, “any sort of rollback of Medicaid will seriously undermine that effort.”

“Twenty-four million people lose health care, and that means 24 million people lose access to mental health benefits” under the GOP plan, Sen. Murphy added, also noting that the AHCA permits states to charge people with mental illness higher premiums, “effectively pricing anybody with a mental illness out of the system.”

Murphy also did not mince words in regards to the AHCA’s handling of America’s growing opioid problem.

“Thousands and thousands of people with addiction will die because of this legislation,” he said. The Centers for Disease Control estimates that opioid overdoses resulted in more than 30,000 deaths in 2015 alone. 

In that vein, then-candidates Donald Trump and Hillary Clinton stressed the importance of combating the escalating opioid epidemic in America, which contributed to one-fifth of all drug, alcohol, and suicide (DAS) deaths of the past decade. According to a 2016 Penn State study, Trump outperformed Mitt Romney is nearly 95 percent of industrial Midwest and Appalachian counties with above-average DAS mortality rates.

“This is a total epidemic,” said Trump in late March, adding that it is “almost un-talked about compared to the severity that we’re witnessing.” 

That said, his pick for assistant secretary for mental health and substance use disorders, Dr. Elinore McCance-Katz, has been sharply criticized by Rep. Murphy. The post, part of the Department of Health and Human Services, was created by Murphy’s Helping Families in Mental Health Crisis Act.

“I’m flabbergasted,” Murphy said last Wednesday on C-SPAN’s “Washington Journal” about McCance-Katz’s nomination, questioning both her ethical standards and leadership ability from her time at the Substance Abuse and Mental Health Services Administration.

Given the approaching Memorial Day congressional recess, many Republicans are feeling the pressure to advance the AHCA given concerns the repeal fight will lose momentum while lawmakers are back in their districts, and their interest in taking up tax reform soon.

“My focus,” Sen. Murphy responded, “is on helping my colleagues in the House make sure it never gets to the Senate. I don’t think there’s an appetite in the Senate for the kind of draconian measures in this bill.”

Ford Carson is an editorial intern for RealClearPolitics. He can be reached at

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