Change in Washington… Is seismic President Trump and new Administration New Republican-controlled Congress New Cabinet New federal agency heads Opportunity to appoint first Assistant Secretary for Mental Health and Substance Use

And a legacy… Overwhelming bipartisan support for behavioral health Mental Health & Addiction Parity law 21st Century Cures law (with Helping Families in Mental Health Crisis) Comprehensive Addiction & Recovery Act

Opportunities for Behavioral Health To build on the bipartisan support for behavioral health To build new champions for behavioral health

Repeal and Replace American Health Care Act (AHCA)

What is repealed? Individual mandate penalty Subsidies Phase-out of Medicaid expansion in 2020

What is replaced? Refundable tax credits Continuous coverage (or 30% penalty) Medicaid per-capita caps Patient and State Stability Fund Restore DSH for non-Medicaid expansion states

What is retained? Essential Health Benefits for commercial market Parity protections, including those for: Small group market and Individual market Pre-existing condition protection Family coverage up to age 26

Congressional Budget Office estimate 24 million fewer people covered Deficit reduced by $337 billion Medicaid spending reduced by $880 billion New tax credits cost $361 billion (vs. nearly $600 billion for ACA subsidies) Patient and Stability Fund adds $80 billion

2017 NAPHS Advocacy Agenda

Protect health insurance coverage. …including mental health and substance use disorder benefits Particularly important to millions of all ages who experience mental illnesses and substance use disorders. Maintain health insurance requirements that improve access, including those that: Extend family coverage to youth up to age 26 Prevent insurers from discriminating based on pre-existing conditions.

Maintain parity protections. Long guaranteed by law Protections help patients, families, providers, and insurers meet the mental health and substance use disorder needs of insured Americans. continued

Maintain parity protections. BENEFITS OF PARITY Reduces stigma Gets people to the right treatment at the right time Improves access Enables coordination of treatment for mind and body Improves efficiency and effectiveness of healthcare dollars

Remove barriers to access to mental health & substance abuse treatment. Eliminate the Medicaid Institutions for Mental Disease exclusion Would give states flexibility… …thereby increasing access while driving down costs. continued

Remove barriers to access to mental health & substance abuse treatment. Eliminate the Medicare 190-day lifetime limit in a psychiatric hospital Would bring Medicare up to the standard of all other insurance plans. Would expand beneficiary choice, increase access for the most seriously ill, improve continuity of care, and create a more cost- effective Medicare program.

Fund mental health & substance abuse reforms passed by Congress. Implement the Helping Families in Mental Health Crisis provisions in the 21st Century Cures law. Paramount is appointment/confirmation of newly authorized Assistant Secretary for Mental Health and Substance Use. Fund all grant programs authorized by law (including those on suicide prevention, workforce, and integration of medical and behavioral services). continued

Fund mental health & substance abuse reforms passed by Congress. Implement the Comprehensive Addiction Recovery Act law. Fund addiction programs.

Get involved We can move forward together Need your help We are listening to you…

2017 strategy Build Champions NAPHS Political Action Committee Member engagement

For more information www.naphs.org