Mental Health on Capitol Hill Update

10/19/2017

This summer, with the help of your advocacy, we defeated Congress’ efforts to repeal and replace the Affordable Care Act. And just a few weeks ago, we fought back again against the dangerous Graham-Cassidy health reform bill.

Now, the White House has announced plans that would make significant changes to mental health coverage. Meanwhile, congressional leaders are working toward reauthorizing the Children’s Health Insurance Program (CHIP) and have forged a tentative bipartisan agreement to stabilize the insurance markets.

CHIP Reauthorization Update

The CHIP reauthorization expired on Sept. 30. Without reauthorization, states will start exhausting their funds for CHIP. Without renewed federal funding, health coverage will end for low-income children, including children with mental health conditions.

The good news is that both the House and Senate—on both sides of the aisle—support the CHIP program. And, they are making progress toward a reauthorization bill.

The main point of debate is on how Congress will pay for the CHIP program. One proposal would raise cost-sharing for people who receive Medicare Part D Low-Income Subsidy (LIS) program help, including many people with serious mental illness. The LIS program helps more than 11 million low-income Medicare beneficiaries afford medications.

NAMI strongly opposes higher cost-sharing for Medicare Part D LIS beneficiaries.

Health Insurance Marketplace Executive Order

On Oct. 12, President Trump signed an executive order (EO) that directs federal agencies to take actions that would let health plans that don’t meet the rules of the Affordable Care Act to be sold in individual and small group markets.

What Does This Mean for People with Mental Illness?

The EO means that health insurance plans may be sold that:

  • Charge you more if you have a mental health or substance use condition
  • Place lifetime or yearly limits on your mental health coverage
  • Do not cover mental health or substance use conditions
  • Do not cover prescription drugs
  • Do not cover pre-existing conditions, including mental illness

If this happens, it will drive up rates for people with mental illness who have more comprehensive plans. And it could leave young, healthy people on limited plans that don’t cover them adequately when they experience mental illness or substance use conditions.

Read more about the excutive order and stay tuned. This EO will not take immediate effect. NAMI will keep you posted as federal agencies develop guidance or regulations.

Cost-Sharing Reduction (CSR) Payments 

On Oct. 13, President Trump announced a plan to end cost-sharing subsidies to health insurers that help low and middle-income people pay for premiums and out-of-pocket costs for their insurance coverage. These subsidies make health insurance more affordable for nearly 6 million Americans.

The non-partisan Congressional Budget Office estimates that ending funding to support CSR benefits will:

  • Drive up premiums for the most common marketplace plans by about 20 percent in 2018
  • Increase the federal deficit by as much as $194 billion over the next 10 years

A Bipartisan Agreement

Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) announced a bipartisan agreement to help keep insurance markets sound and more affordable. If this bill passes, it will help protect mental health coverage for Americans with mental illness.

The Alexander-Murray bill will also keep vital patient protections in place, including stopping health plans from:

  • Dropping coverage of mental health and substance use
  • Charging higher premiums if an individual has a preexisting condition, like depression or anxiety
  • Charging more simply because a person has a mental health or substance use condition

The Alexander-Murray bill will strengthen and stabilize the health care system, reducing the risk of sharp premium increases and lack of insurance options. It maintains important cost-sharing reduction (CSR) subsidies and financial assistance, which help low- and middle-income people pay for out-of-pocket costs and insurance premiums.

Your continued advocacy matters.

Contact your senators and tell them to support this bipartisan effort and protect mental health coverage for millions of Americans.

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