Revised Senate Health Care Bill Worse Than First Version, APA Says

Two-tiered insurance markets would force most vulnerable into more-expensive plans

WASHINGTON — The latest version of the Senate bill to repeal and replace the Affordable Care Act, the Better Care Reconciliation Act of 2017, is more damaging than the original draft, since it would support the creation of bare-bones health insurance policies that do not cover mental health and substance-use treatment and other vital services, according to the American Psychological Association. 

The new bill would also weaken current legal protections, making coverage much more expensive — and perhaps unaffordable — for people with pre-existing conditions, including mental health and substance-use disorders, according to the APA.

‘This bill will not only irreparably damage Medicaid, like the first version, but it will also fracture the private insurance market,” said APA President Antonio E. Puente, PhD. “We urge the Senate to reject this measure and instead focus on making improvements to the Affordable Care Act to strengthen the state health insurance exchanges and cover more people.”

The new bill retains many of the objectionable provisions of the first iteration, Puente said. Like the House-passed American Health Care Act, the Senate bill would allow states to waive the Affordable Care Act's essential health benefit requirement, make draconian cuts to Medicaid, dramatically increase premiums for older Americans, restrict access to reproductive health and other vital health services, and eliminate the Prevention and Public Health Fund. Before the Affordable Care Act was enacted, health plans in the individual and small group market often declined to cover mental health and substance-use disorder services. 

While the new bill would add $45 billion over nine years in grant funding for states to combat the opioid epidemic, that sum is woefully inadequate, Puente said. “Not only is the amount insufficient to meet the need, a grant program is no substitute for reliable health insurance coverage, which ensures timely access to treatment services," Puente said. "The $45 billion is inadequate given the millions of people who will lose coverage as a result of cuts to Medicaid or the inability to afford other insurance." 

“APA and the APA Practice Organization continue to urge Congress to pass health care legislation that would increase, not decrease, the number of Americans with mental health and substance-use coverage,” said APA CEO Arthur C. Evans Jr. PhD. “APA is committed to achieving universal access to mental health and substance-use services — at parity with physical health services — and ensuring access to prevention, early intervention and health promotion services.” 

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.