March 16, 2017

APA Calls Upon Congress to Oppose American Health Care Act

Expresses concern to House leaders over Congressional Budget Office analysis

WASHINGTON — The American Psychological Association and its affiliated APA Practice Organization sent a letter (PDF, 96KB) to congressional leaders stating their opposition to the American Health Care Act after a Congressional Budget Office analysis projected that the bill, if enacted into law, could double the proportion of Americans without health insurance by 2026.

“We believe that any health care reform legislation to repeal and replace the Patient Protection and Affordable Care Act considered by Congress should increase the number of Americans with coverage for mental health and substance use disorder services, including behavioral health treatment,” said the letter to Speaker of the House Paul Ryan, R-Wis., and House Minority Leader Nancy Pelosi, D-Calif., signed by APA President Antonio Puente, PhD, and Interim CEO Cynthia Belar, PhD. “As the recent analysis by the Congressional Budget Office concludes, the American Health Care Act would significantly decrease Americans' access to these services, and by 2026 would take coverage away from an estimated 24 million people who would have otherwise been covered under current law.”

The letter voiced concern that the AHCA would severely undermine Medicaid by instituting per capita caps in federal payments to states that would not keep pace with per enrollee spending growth and by eliminating the Medicaid expansion for Americans with incomes below 138% of the federal poverty level. The CBO projected the AHCA would cut Medicaid spending by $880 billion over the next ten years and remove coverage from 14 million beneficiaries by 2026.

“These cuts are unconscionable in light of the large unmet need for mental and behavioral health and substance use services, as evidenced by the tens of thousands of Americans dying each year due to opioid addiction,” said the letter. “By drastically reducing federal spending for Medicaid, and by removing the requirement that Medicaid benchmark plans cover mental health, substance use, and behavioral health services, the American Health Care Act would jeopardize coverage for these life-saving treatments for the entire Medicaid population.”

The letter also expressed concern at the elimination of vitally important funding for the Prevention and Public Health Fund, and its prohibition on funding for providers that primarily offer reproductive health services under Medicaid. This change would effectively cut off access to care for many low-income women and sexual and gender minorities, many of whom would not have access to health care if they could not access these service providers. The CBO analysis projected that the proposed cuts in Medicaid funding to reproductive health care providers would increase Medicaid spending by $21 million in the first year.

In addition, the CBO estimated that the AHCA would reduce the quality and reliability of private sector insurance by allowing plans to offer coverage with less actuarial value, increase out-of-pocket costs for lower-income and less healthy Americans and make it harder to shop for and compare plans.

“While we support efforts to strengthen and stabilize our nation’s health care system and extend insurance coverage and protections, we oppose the American Health Care Act due to the adverse impact it will have on Americans with mental health, behavioral and substance use disorders,” said the letter.

Copies of the letter were also sent to Senate Majority Leader Mitch McConnell, R-Ky., and Senate Minority Leader Charles Schumer, D-N.Y.

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States. APA's membership includes nearly 115,700 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance the creation, communication and application of psychological knowledge to benefit society and improve people's lives.