Trumpcare Is Bad For Mental Health Coverage


On May 4, the House of Representatives narrowly passed the Republican regime’s new health plan, known as the American Health Care Act (AHCA), or Trumpcare. This is a win for Republicans, many of whom promised their constituents that they would finally repeal Obamacare. The AHCA is different from Obamacare in many ways, and NPR does a great job of breaking down the main provisions of the new health care bill. One of the ways the AHCA is so different from Obamacare is by how it addresses mental health.


One of the provisions of the AHCA permits states to apply for waivers that allow insurers in their state to eliminate Obamacare-required “essential health benefits” from their plans. The removal of required essential health benefits, which include mental health and addiction services, will likely lead to cheaper, and therefore more affordable, health plans. But, of course, it comes at a cost—while these cheaper plans seem like a good deal for consumers, they actually provide barebones coverage that excludes mental health care. The sad thing is that many consumers aren’t fully aware of the barebones coverage their more ‘affordable’ plan provides. This isn’t necessarily the consumer’s fault, considering how complicated insurance language is….but, that’s a story for another day. The exclusion of behavioral health care is crippling, considering 1 in 5 adults experience mental illness within a given year. The loss of essential addiction services is also harmful, especially in the midst of the U.S.’s opioid epidemic, which claims the lives of 78 people everyday.


Another provision of the AHCA caps state spending on Medicaid, which is the largest insurer of mental health services in the U.S. Studies show that low income individuals—who are likely to enroll in Medicaid—are at greater risk of developing mental illnesses, and also face greater barriers to accessing health care. With that said, AHCA’s diminishing coverage of mental health care can potentially be extremely debilitating for precarious populations that need it the most.   


While Obamacare expanded Medicaid and required all plans to include mental health coverage, it didn’t perfectly address mental health care needs. For example, according to Rep. Joe Kennedy of Massachusetts, mental health reimbursement rates are still poor and insurance companies exploit parity laws that requires them to treat mental health the same as physical health. Also, the number of individuals going on disability due to mental illness has increased steadily over the years, which may be due to poor quality of mental health care. Republicans had the opportunity to address all of these issues, but they didn’t. Instead, they made coverage worse by capping Medicaid spending and allowing states to remove essential health benefits.


In terms of behavioral health coverage, the AHCA is a very clear step down from Obamacare. For good reason, the bill has been denounced by many, including the American Medical Association. Fortunately, the Senate will not pass the House’s flawed, partisan bill, and will opt to write their own. Let’s hope they consider major complaints and draft a new bill that places greater emphasis on people’s health, rather than politics.

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Imaz Athar

Imaz Athar is a senior undergraduate student at the University of Pittsburgh, double majoring in Neuroscience and Sociology. He aspires to become a physician and plans on attending medical school in Fall 2017. Imaz fell in love with the art of writing at a young age and is currently the Publisher of Pitt's undergraduate-run science magazine The Pitt Pulse. When he's not writing or keeping up with classes, Imaz enjoys running, playing basketball, watching Empire, singing (in the shower), and listening to all kinds of music.