Dismantling ACA endangers mental health care

Through executive orders and roll call votes, the new administration has begun the process of dismantling the Affordable Care Act (ACA), commonly known as Obamacare.

While the health care law is by no means perfect, the ACA has produced tangible benefits in reducing the number of people without insurance from 49 million in 2010 to 29 million in 2015.

In Pennsylvania, the uninsured rate dropped from 10.2 to 6.2 during this same five-year period.

Repealing the ACA without an immediate replacement will jeopardize the immediate gains the law has made in expanding insurance coverage and the types of insurance benefits offered to individuals.

One of the areas in which the ACA has been most transformative is mental health. Psychiatric disorders, including depression, anxiety, and addiction disorders, are estimated to affect one in four adults in the United States. Among these individuals with the most serious mental illness, the treatment cost was estimated to be $300 billion in just 2014 alone.

While the mortality from virtually every other disease type has declined since the 1960s, deaths from psychiatric illness have remained unchanged over the last five decades.

The Mental Health Parity Act and Addiction Equity Act of 2008 transformed the field of mental health care by requiring large-group insurance plans to provide comparable reimbursements for psychiatric services as other medical services.

The ACA expanded the reach of this law by listing mental health care as an Essential Health Benefit that even small and individual insurance plans must offer. Furthermore, it broadened the criteria for Medicaid, a population that has a disproportionately high incidence of severe mental illness.

Psychiatric disorders are caused abnormal patterns of neuron firing in the brain. However we do not yet understand what causes these patterns of abnormal activity and how they can be corrected.

As a neuroscience graduate student, I chose to dedicate my research to studying the brain circuits of psychiatric disorders as I believe this has the possibility to transform a neglected area of medicine.

I hope that this research will not only lead to more effective therapeutics, but will also uncover the biological basis behind what causes these disorders. The symptoms of people living with mental illness are as real as any other medical condition, and it is my strong desire that this better understanding will remove the stigma associated with receiving mental health treatment.

Now more than ever, it is essential to act to ensure mental health treatment for all. If the Affordable Care Act were repealed, 1.1 million Pennsylvanians would lose health care coverage. Included in this are 690,000 individuals who would lose coverage due to the expansion of Medicaid.

-0The expansion of this program has been particularly effective in improving access to treatment for substance use disorders with 63,000 people who were newly eligible for Medicaid taking advantage of the Drug and Alcohol Treatment Program just in our state alone.

One needs to look no further than headlines to understand the seriousness of the drug addiction crisis at hand.

Over the past decade the rate of addiction to opiate drugs has increased sharply and has resulted in drug overdoses passing car accidents as the leading cause of accidental deaths (5). Pennsylvania has been particularly hard hit by the epidemic, and has the 9th highest rate of drug overdoses nationally.

In recognizing this, Governor Wolf has secured $20.4 million for the current fiscal year to establish 45 Centers of Excellence for the treatment of opioid addiction throughout the state. This fight has been further continued at the national level by the 21st Century Cures Act led by Pennsylvania’s Representative Tim Murphy.

This new law, which passed with an overwhelming majority in both houses of Congress, provides additional funding for neuroscience research and expands the power of regulators to monitor mental health parity compliance.

I am asking you to join our fight to save mental health care reform.

Write to your representatives in Congress and telling them why it is important to save the expansion of Medicaid and keep mental health as an essential health benefit.