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APA’s Efforts to Fight Senate Health Care Bill


After Congress returns from its July 4th recess, Senate Republicans will resume their efforts to repeal and replace the Affordable Care Act (ACA), better known as Obamacare. The bill, the Better Care Reconciliation Act (BCRA), was recently scored by the Congressional Budget Office (CBO), and the findings paint a grim picture for the future of health care should it become law.

According to analysis from the CBO, more than 22 million Americans would lose coverage by 2026 should the Senate’s proposed legislation pass. That number is troubling to say the least, but perhaps even more disturbing is what kind of ripple effect such a loss of coverage would have for patient populations across the United States, particularly regarding mental health and substance use disorders. This is why the APA has taken such a public stance against this bill.

We are not alone. We have joined with five other medical organizations – the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, the American Congress of Obstetricians and Gynecologists and the American Osteopathic Association – in Hill visits with key lawmakers so we can speak out on behalf of our members and our patients. Together we represent more than half a million frontline physicians.

In addition, the APA and the American Psychological Association sent a letter to the Senate leadership that called on the Senate to reject the bill on the grounds that it would penalize those currently receiving mental health and substance use treatment by eliminating protections for preexisting conditions put in place by the ACA. The letter, co-signed by myself and Arthur C. Evans Jr., CEO and executive vice president of the American Psychological Association, points out the dangers in capping federal Medicaid payments while the country is in the throes of an opioid epidemic that has devastated communities across the country and shown no regard for race or social class.

Insurance payments for opioid use and dependence services have skyrocketed in recent years. Many of those who are covered and receiving treatment today would be denied service if the proposed legislation were to pass. The result, unquestionably, would be thousands more dead from an epidemic that in 2016 alone claimed more American lives than the entirety of the Vietnam War.

That, of course, is to say nothing about the millions of Americans who receive treatment for depression, schizophrenia, PTSD and other serious mental illnesses that can often result in death if left unchecked and untreated. Any bill that removes patient protection for preexisting conditions, which the Senate bill does, would allow insurers to once again pick and choose who they cover to avoid financial responsibility for the essential services. For those who depend on these services to maintain their quality of life, and indeed to stay alive, the outcome would be ruinous.

The APA has been vocal in our opposition to this legislation, which to date has been drafted behind closed doors and without input from any patient or physician group, and we will continue to oppose it until the bill represents a true bipartisan effort to increase access and quality of care for all Americans. We will continue to be active in our efforts on Capitol Hill, but your voice is needed too. Please reach out to your Senators and Representatives and urge them to reject this legislation.

What APA is Doing For You

This blog post is part of an occasional series highlighting how APA advocates on your behalf to support the profession of psychiatry and put our interests before key policymakers.


Post by Saul Levin M.D., M.P.A.

Saul Levin, M.D., M.P.A., FRCP-E, is APA's CEO and Medical Director. Read Dr. Levin's full biography

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CEO BlogWhat APA is Doing for You


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