The newly released Senate health care bill does nothing to address the concerns the mental health community had with the first version. Allowing health plans to not cover treatment that affects 1 in 5 Americans (mental illnesses), or to not cover treatment with substance-use disorders during an opioid crisis, simply doesn't make sense. We remember when plans weren't required to cover such treatment, leaving families devastated or leading to poor outcomes such as unemployment, homelessness, criminal-justice involvement or suicide. "Austere plans" really mean plans that won't cover the illness you might develop. Unfortunately, we don't get to choose which illnesses we develop.
The Senate bill would continue to cap Medicaid funding to states, which is particularly concerning, since we are in the midst of building our mental health system. The costs of increasing access won't be included in those caps. Medicaid is the largest funder of mental health services, and more Minnesotans were able to have insurance cover their treatment than ever before. Limiting funding is arbitrary and has no connection with innovation, quality or cost-effective measures.
These changes will reverse the progress we have made. The bill obstructs our vision for the future. Once again mental health treatment is not viewed as necessary.
Sue Abderholden, St. Paul
The writer is executive director of NAMI (the National Alliance on Mental Illness) Minnesota.
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Blanket programs of health care insurance coverage do not lend themselves well to the precepts of the insurance mechanism. I agree with U.S. Sen. Ted Cruz that those experiencing known severe health problems should (and generally do) pay far more for their health care ("Senate consumer choice idea may raise premiums for sick," July 13). One prime example is Medicaid, where we require spending down assets and income to qualify for this government program of last resort. We all must work hard for our best health outcomes and realize every incentive to do so.
Should young healthy families, struggling financially to make ends meet, really be expected to pay higher insurance rates to subsidize those requiring extreme health care? Common-sense underwriting for every other type of insurance mandates screening out obvious high-risk individuals and businesses that don't meet underwriting standards.
We do need that high-risk, government-subsidized pool for those not qualifying for standard health care policies, similar to Medicaid. Individuals might be expected to contribute a certain percentage of income and assets to their health care needs to qualify for that pool. The irony of all this is that we the taxpayers will only pay for their care through taxes rather than higher insurance premiums. Thankfully, the wealthy, able to afford those higher tax subsidies, will pay those taxes and never miss the money. We should also tax the excessive profits of the entire medical industry to pay for that pool. Finally, we need to reduce all the fraud and inefficiencies that drive up costs.