Today, Congress is voting on the American Health Care Act (AHCA), the Obamacare replacement bill.
As of yesterday, the Congressional Budget Office (CBO) continued to estimate 24 million people will lose health insurance coverage in the next ten years, and among those that have coverage, they will have less. While these numbers are probably far from exact, no one else has provided a competing analysis and there is no reason to doubt the overall trends.
MHA believes that we should treat mental health conditions before stage 4 – we don’t wait until stage 4 for cancer, we treat it as early as possible, and we should do the same for mental health. What does the AHCA mean for acting before stage 4?
With the AHCA, millions of people will have to pay more out-of-pocket to get mental health and substance use treatment, either because they have no coverage or they have less coverage. When people have to pay out of pocket, they don’t get treatment before stage 4. They wait until they are so sick that they feel like they really have no other choice but to pay. Then treatments will be more intensive and expensive, and the road to recovery longer.
The AHCA also impact the providers. The AHCA cuts hundreds of billions of dollars in federal assistance to states. When budgets get tight, especially in Medicaid, the first thing to get cut will be new programs and innovations – no one starts taking risks in a budget crisis. It is hard to imagine that we will continue to see mental health innovation under the AHCA, and many of the existing programs might return to treatment as usual – bringing us back to treatment mostly at stage 4.
Even worse, the CBO analysis also only looks ten years into the future. The early mental health symptoms that go untreated under the AHCA will take a few years to get really bad. Half of all mental health conditions emerge by age fourteen, but these often only start really taking a toll a decade or two later. At this point, we’ll start to see people in our communities really start to struggle. While the CBO can’t look beyond ten years, we can.
MHA is open to other analyses, but using what we have all indications are that the AHCA will not take us in the right direction on before stage 4. Hopefully Congress members look out for the mental health of our country and work with MHA to come up with better health policy. We should make health care more affordable and reduce the federal deficit by getting people effective mental health treatment when they first need it – not by giving them less treatment and hoping for the best.
