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APA Urges Senate HELP Committee to Preserve Essential Health Care Benefits

     

This month, the U.S. Senate Committee on Health, Education, Labor and Pensions (HELP) has been holding hearings on stabilizing premiums and helping individuals in the individual insurance market for 2018, with a key hearing this Thursday.

With hearings of this nature, it is vital that stakeholders make their voices heard to the lawmakers who will be shaping the health care policy of the future. That is why the American Psychiatric Association has joined with five other medical specialty associations to issue a joint statement on behalf of the 560,000 physicians and medical students we represent that outlines our recommendations to stabilize the insurance market and ensure that all patients have access to affordable and comprehensive health care coverage.

The recommendations outlined in that letter apply broadly across the house of medicine. They include providing funding for long-term, cost-sharing reductions; continuing reinsurance and other premium stabilization programs; enhanced outreach and education efforts for the public on the insurance marketplace; enforcing the individual mandate to purchase coverage; and expanding competition and choice by offering a public option in all exchange markets. I firmly believe that these recommendations will help to stabilize the insurance marketplace in the U.S., and lead to better, more affordable coverage for millions of Americans.

As psychiatrists, we are medical leaders for the mind, brain and body. As experts in the diagnosis and treatment of mental illness and substance use disorders, we have a duty to help ensure that our patients have treatment options at their disposal that are both affordable and accessible. That is why APA has sent a separate letter to the Senate HELP Committee members urging them to preserve access to treatment for mental health and substance use disorders for all Americans.

This is especially vital when you consider the opioid abuse epidemic that is gripping the country. According to the Centers for Disease Control and Prevention, there were 22,000 deaths involving prescription opioids in 2015 alone. The economic and human costs of this epidemic are already far too great to bear, and without treatment that is affordable and accessible, they will surely rise.

To combat this epidemic, there must be a stable insurance market in place. We believe that affordability and accessibility should be co-existing, not competing goals. Cost-sharing reduction (CSR) payments to insurers must be maintained at their current levels throughout at least the 2018 coverage year to keep co-pays and co-insurance requirements low for plan members. CSR payments are necessary to ensure that insurance companies do not withdraw from the Affordable Care Act marketplaces, an outcome that would leave low-income enrollees who are sicker or older — many of whom suffer from mental illness and/or substance use disorders — without affordable coverage.

The ACA’s prohibition against denying coverage based on a pre-existing condition must also be preserved, as well as the prohibition against annual and life-time limits on coverage. Treatment services for mental health and substance use disorders are very often lifesaving for the patients who need them. As such, they must be retained as essential health benefits (EHBs).

Comprehensive and affordable coverage for health care, including treatment for mental health and substance use disorders, is essential to combating crises like the opioid epidemic, as well as improving the overall health of the nation. We will continue to provide lawmakers in Washington with our insight and expertise into these matters in the hopes that the policy they craft results in better outcomes for our patients, and for all Americans.

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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