The US Senate may take action this week on the Graham-Cassidy health care bill, a last-ditch effort by Senate Republicans to repeal and replace the Affordable Care Act. If Graham-Cassidy becomes law, the consequences for US mental health providers and their clients would be disastrous.
The nonpartisan Congressional Budget Office will not score the bill before a September 30 deadline for Senators to vote on it. But estimates suggest that under the bill, at least 16 million Americans would lose health insurance entirely after 10 years, given the bill’s similarity to prior Republican health care bills. This would leave millions paying out of pocket for mental health care that is currently covered by insurance.
For those who retain health coverage, Graham-Cassidy would allow states to waive existing requirements that insurance plans cover mental health care. Insurers would also be allowed once again to treat prior mental health care as evidence of a pre-existing condition, significantly increasing insurance premiums for those who have seen a therapist or used psychotropic medication in the past. Ultimately, millions of Americans who can now access mental health care under their insurance would no longer be able to do so. Millions more may see costs associated with mental health care increase dramatically.
Given these impacts, the American Psychological Association and American Psychiatric Association have formally opposed the bill. Other mental health organizations have also expressed concerns.
As of last Friday, it was unclear whether the Graham-Cassidy measure would even come up for a vote. Senator John McCain announced that he would vote against the proposal. Combined with opposition from Senator Rand Paul and what is considered likely opposition from Senators Ted Cruz, Susan Collins, and Mike Lee, McCain’s opposition may help ensure that the bill cannot advance.
If the Senate is unable to pass a bill before the September 30 deadline for the budget reconciliation process, any other health care bill put forward this year, under current rules, would need 60 votes to advance. That means that any bill with unified opposition from Democrats would not be able to move forward.