Your mental health could be at risk
St. Lucie News Tribune - 5/14/2017
Don't panic yet, but your mental health could be at risk.
A week ago, the U.S. House of Representatives narrowly passed the American Health Care Act, which repealed key provisions of the Affordable Care Act and takes aim at slashing $882 billion out of the Medicaid program.
The bill included a late amendment that rolled back essential health benefits and protections for those with pre-existing conditions. That could include mental health and addiction disorders.
Did our representatives forget we're up to our necks in an opioid addiction crisis that kills 78 Americans every day? Do they realize 43.6 million U.S. adults live with a psychiatric illness and 16.3 million have an alcohol-use disorder?
According to the National Council for Behavioral Health (Motto: Mental Health First Aid. Healthy minds, strong communities), the AHCA "will have devastating effects on patients' (access) to affordable and comprehensive care. Patients with mental health and addiction disorders will be especially hurt as they disproportionately rely on traditional Medicaid" for coverage.
John Romano, chief executive officer for mental health services provider New Horizons of the Treasure Coast & Okeechobee, noted Medicaid is the single largest mental-health payer in the country.
"The feds are going to allow states to set their own levels of Medicaid (after 2020) and that could cause problems," Romano said.
The overall level of coverage that will be provided is still very much up in the air, Romano said, but as the Medicaid system moves to a per-person allotment, the effects could be worrying.
"The caps per individual," Romano explained, "will be based on 2016 levels that by 2020 will be four years out of date and are likely to be insufficient in a climate of rising healthcare costs."
So, yes, we could see some real problems with basic mental health coverage.
"Cuts to Medicaid would mean the suicide rate will increase, that use of emergency rooms will increase and that our jails will get fuller," both Romano and New Horizons' chief clinical officer Deb Dreher agreed.
Dreher also noted "people with mental illness tend to die 25 years sooner than the general population because they often do not have adequate access to health care. Many have complex, multiple pre-existing conditions and their costs are higher. Cuts to that population will really hurt."
"Our only hope is that the Senate can tone this (AHCA) down and preserve some services and money," Romano noted. "The Senate could either re-do the bill entirely or modify it. Reconciliation (between House and Senate versions) could take a long time."
The only bright spot here is that any real changes could be months, if not years, away.
"We're waiting to see what happens," Romano added. "I think the Senate will have to throw a lifesaver to clients. Hopefully, it'll be a lot more for their benefit. We have a long way to go, but in the meantime if people call their senators perhaps that will help. I hope so."
Not surprisingly Sens. Bill Nelson (D) and Marco Rubio (R) seem worlds apart on the issue.
Nelson immediately denounced the AHCA when it passed May 4. During a media event in Pensacola a week ago, Nelson characterized the AHCA as "rushed" and "deficient."
"That doesn't have a chance of passing the Senate," he declared.
Nelson said he's part of a group of bipartisan Senate "consensus builders," who will work to update the Affordable Care Act and get it operating more efficiently. He admitted the current political atmosphere around the American Health Care Act is starkly partisan, but said he believed the Senate would come together to create legislation that was good for all Americans.
"I'm hoping that's the atmosphere once this falls on its face," Nelson said of the House bill.
Rubio's position on the AHCA is much less clear. He has been conspicuously silent on the issue so far. Editorials in the Miami Herald and (Fort Lauderdale) Sun-Sentinel last week both encouraged Rubio to join the ranks of fellow Republican AHCA doubters.
"The message is unmistakable," the Herald thundered. "You have to care ... Care enough to realize your constituents in Florida ... are worried sick about the Trumpcare bill the House passed last week."
"Access to affordable health insurance determines whether lives are expanded or shortened," the Sun-Sentinel opined. "The Senate should turn away this pay-more, get-less bill, no matter that Republicans have pushed to repeal Obamacare for seven years. This is a bad deal for Americans."
Last week, a friend posted on Facebook a list of 92 pre-existing conditions that won't be covered under the AHCA. I have six of them, mostly byproducts of advancing years or a less-than-healthy lifestyle. I suspect most Americans over the age of 50 are members of the same club.
Perhaps if we'd exercised more, eaten better or never smoked, we'd be healthier now. But those were our choices. What about someone who suffers from mental illness through no fault of their own? Our health care system should never discriminate against those who have no choice in their well-being.
Write or call your senators. They might be our only salvation.
Anthony Westbury is a columnist for Treasure Coast Newspapers. This column reflects his opinions. Contact him at 772-221-4220, firstname.lastname@example.org, or follow him @TCPalmWestbury on Twitter.
Sen. Bill Nelson
716 Hart Senate Office Building
Washington, DC 20510
Sen. Marco Rubio
284 Russell Senate Office Building
Washington, DC 20510