Gillespie Once Again Silent on Trumpcare’s Devastating Cuts to Mental Health and Addiction Treatment

Let’s be clear: if Gillespie really cared about the more than 1.3 million Virginians suffering from mental health and substance abuse problems, he would immediately stand up to Donald Trump and come out against the Senate healthcare bill.  The Senate health care bill would gut funding for Medicaid and Virginia’s GAP program — which is critical to treating opioid abuse and mental health in the commonwealth. Even worse, it would allow states to seek a waiver that would allow insurance companies to charge extremely high costs for mental health and substance use disorder coverage to Virginians. In the process, veterans suffering from mental health illnesses like PTSD could lose their access to the care they need.

“If Ed Gillespie was serious about helping the more than 1.3 million Virginians struggling with mental health illness, he would immediately come out against Trumpcare,” saidKevin Donohoe, DPVA spokesperson. “Trumpcare’s devastating cuts to programs that support mental health care and substance use disorder would be a historic attack against Virginia’s treatment and recovery services. Any serious plan to address mental health and substance use disorder starts with standing up to Donald Trump and rejecting his cruel plan to take away care from hundreds of thousands of Virginians.”

Background on Trumpcare’s Potential Impact on Mental Health

Virginia’s GAP Program To Treat Substance Use Disorder And Mental Health, Which Relies On A Medicaid Waiver For Funding, Is “Just The Kind Of Program That Might Have To Be Altered Or Eliminated.” “POPE: Late last year, Virginia declared the opioid crisis a public health emergency, one that might be much more difficult to treat under the proposals now under consideration in Washington. Laura Goren at The Commonwealth Institute says those bills would undo years of work by state officials to get a handle on the problem. GOREN: The bills would put us back a decade in time to when states allowed insurance companies to exclude coverage for some essential healthcare, and that very likely includes substance use treatment. POPE: One of the treatment services that might be on the chopping block is the Governor’s Access Plan, known as GAP, that provides addiction recovery services for low-income people with serious mental illness. Jill Hanken at the Virginia Poverty Law Center fears that kind of program would be first to be cut. HANKEN: A program like the GAP program, which is a waiver service – an extra service beyond what’s absolutely required under Medicaid – is just the kind of program that might have to be altered or eliminated. POPE: The Virginia Department of Medical Assistance Services estimates that the bill currently under consideration in the Senate would cost Virginia’s Medicaid program at least $1.7 billion dollars over seven years. That could mean dramatic cuts to treatment services at a time when the opioid crisis continues to spiral out of control.” [Virginia Public Radio, 6/28/17]

The Senate And House Trumpcare Bills Allow States To Strip Away Essential Health Benefits, Including Those For Substance Use Disorder And Mental Health Treatment. “The ACA established a federal minimum for what private insurers must cover for 10 ‘Essential Health Benefits’ (EHBs) including substance use disorder and mental health treatment, providing millions with access to SUD treatments. The efforts to repeal and replace the ACA from both the House and the Senate will put all of these gains on the chopping block. Like the House version of the AHCA, the Senate bill will likely allow states to strip away EHBs.” [The Commonwealth Institute, 6/21/17]

• The CBO Determined That Mental Health And Substance Use Disorders Are Some Of The “Most Likely To Be Dropped” When Essential Health Benefits Are Waived. “The Congressional Budget Office (CBO) determined that, when EHB standards aren’t required, mental health and SUD treatments are one of the most likely to be dropped.” [The Commonwealth Institute, 6/21/17]
• Mental Health Conditions And Substance Use Disorders Affect More Than 1.3 Million Virginia Adults Between 18 And 64. “Yet, mental health conditions and substance use disorders are among the most common pre-existing conditions, affecting more than 1.3 million adults in Virginia between 18 and 64.” [The Commonwealth Institute, 6/21/17]
• Stripping These Treatments Out Of Essential Health Benefits Would Mean They Would Have Extremely High Premiums As Well As Higher Out-Of-Pocket Expenses. “U.S. Senate Republicans are touting that their legislation would not allow insurers to deny coverage to people with pre-existing conditions. But saying that people would not be denied coverage is not the same as saying people would be able to receive needed treatment. Costs for plans without EHBs might be lower, but plans that continue to cover them would have extremely high premiums as well as higher out-of-pocket expenses (since mostly individuals with pre-existing conditions would be likely to enroll in them).” [The Commonwealth Institute, 6/21/17]
• Decreasing Access To Mental Health Coverage “Could Be Detrimental For Vets, Who Suffer From Mental Health Issues Like PTSD.” “A 2015 survey from the nonprofit Iraq & Afghanistan Veterans of America found that 58% of respondents reported having a mental health injury due to their service. Decreasing mental health coverage for Medicaid enrollees could be detrimental for vets, who suffer from mental health issues like PTSD and are at higher risks of suicide than the general population.” [Time, 3/15/17]

Medicaid And CHIP, Threatened Under Trumpcare, Cover Three Out Of Ten People With Opioid Addictions, And At Least 40,000 Virginians On Medicaid Have A Substance Use Disorder. “Removing the protections of the EHB coverages is not all that the AHCA bills would do to limit access and coverage for treatment for opioid addiction and other substance use disorders. The AHCA proposals would also weaken the structure and financing of Medicaid. It’s not just the sharp projected cuts in funding; under a per-capita cap Virginia would receive only a fixed amount of federal funds for Medicaid, even if medical expenses increased sharply (due to an addiction-related public health crisis, for example). Medicaid and the Children’s Health Insurance Program are particularly important because these programs cover 3 in 10 people with opioid addiction. At least 40,000 people in our state’s Medicaid program have a substance use disorder.” [The Commonwealth Institute, 6/21/17]