2. 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

3. 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

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

5. Repeal and Replace
American Health Care Act (AHCA)

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 What is repealed?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

7. 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

8. 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

9. 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

10. 2017 NAPHS Advocacy Agenda

11. 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.

12. 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

13. 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

14. 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

15. 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.

16. 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

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

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

19. 2017 strategy Build Champions NAPHS Political Action Committee
Member engagement

20. For more information www.naphs.org