APA Voices Opposition to Revised American Health Care Act

WASHINGTON, April 28 -- The American Psychological Association issued the following news release:

The American Psychological Association and its affiliated APA Practice Organization have called on Congress to reject the amended American Health Care Act, noting that it would allow states to waive essential health benefits, such as mental and behavioral health care and substance use treatment, and charge unfair premiums for individuals with pre-existing conditions.

"We previously communicated our opposition to the initial version of the American Health Care Act due to the adverse impact it would have on Americans with mental health and substance use disorders," APA said in a letter (PDF, 89KB) to House Speaker Paul Ryan, R-Wisc., and Minority Leader Nancy Pelosi, D-Calif. "The recently proposed amendment to the AHCA would only add to these coverage losses."

Instead, APA urged Congress to authorize the Affordable Care Act's cost-sharing reduction payments in order to strengthen the health insurance exchanges. "Without this funding, many health insurers will leave the market, and premiums will rise sharply -- for Americans with coverage both on and off the exchanges -- as plans seek to recoup the loss of billions of dollars in payments they were promised," said the letter, signed by APA President Antonio E. Puente, PhD, and APA CEO Arthur C. Evans, Jr.

The original AHCA, considered by the House in March, would have taken away coverage from an estimated 24 million people by 2026 and severely undermined Medicaid coverage by reducing spending by more than $800 billion over the next 10 years; eliminating the requirement that plans cover an essential benefit package (including mental and behavioral health and substance use treatment); and instituting per capita caps in funding. Combined, these steps would force states to cut 14 million beneficiaries from the program over the next decade and sharply reduce benefits for those who remain. The bill would have also eliminated funding for the Prevention and Public Health Fund and prohibited funding for providers that primarily offer reproductive health services under Medicaid.

The newly proposed amendment to the bill would only make matters worse, according to Puente and Evans. Under the amendment, the AHCA would continue to allow states to waive the Affordable Care Act's essential health benefit requirement, and would also allow states to implement both unfair premium rating ratios by age and medical underwriting of policies for individuals who have a lapse in coverage.

"These changes would allow insurers to once again discriminate based on medical history and make coverage of, and access to, essential services unattainable for many Americans," according to the letter. "Hundreds of thousands of individuals with a pre-existing mental health or substance use disorder would be priced out of coverage or would find that coverage for the services they need was simply no longer available at any price."

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States. APA's membership includes nearly 115,700 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance the creation, communication and application of psychological knowledge to benefit society and improve people's lives.