Letter to the Editor: ACA Health Care Replacement Bill May Impact Every Family in America

Dear Editor,

We are opposed to the Senate draft, released Thursday, June 22 (the Better Care Reconciliation Act of 2017). It will cripple many organizations; such as Tenco, Inc. who is providing services to individuals in 9 counties in Southeast Iowa and Southern Iowa Mental Health Center (SIMHC) providing services to clients in Southeast Iowa and Northeast Missouri.  These two organizations provide support in community mental health and disability services to nearly 3000 Iowans.  Nearly 100% of these services are funded by Medicaid to help these vulnerable Iowans live, learn, and work in their community of choice. Medicaid fundamentally changes to a per capita cap program beginning Fiscal Year 2020. The base year calculation in the Senate version changes use of the FY16 fiscal year to an average of 8 consecutive quarters between first quarter FY14 and third quarter FY17.

The Senate version DECREASES the amount to mental health and disability programs by downgrading the growth rate from the House version. The Senate is creating more federal “savings” with this change.

The 142-page bill would create a new system of federal tax credits to help people buy health insurance, while offering states the ability to drop many of the benefits required by the Affordable Care Act, like maternity care, emergency services and mental health treatment. This is not “better”.

The new bill shifts hundreds of billions of dollars in costs to states. At a time when Iowa faces over $100 million shortfall in its current budget year, this is clearly not sustainable.

The proposed cuts to Medicaid disproportionately harm those who rely on Medicaid for lifesaving opioid addiction treatment, at a time when mortality from the opioid epidemic is growing at a devastating rate. We are facing a national emergency on opioids. The ongoing opiod drug epidemic has killed more than 30,000 people in 2015. And opioid overdoses have quadrupled since 1999.

The proposed one-year grant fund for mental health and addiction treatment in 2018 doesn’t come close to meeting the real—and growing—need for care. Grants are not a substitute for health coverage. We don’t rely on grants for the treatment of heart disease or cancer. Addiction and mental health should be no different.

Congress has made incredible strides in advancing access to care for disability, mental illness, and addiction services in recent years.

On the anniversary of the Olmstead decision, the Senate is proposing a bill that would decimate community services to Iowans. Without funding and supports, community integration (as defined by the Americans with Disabilities Act and affirmed by the Olmstead Supreme Court decision) becomes a meaningless promise.

We URGE everyone to contact their legislators to ensure that revisions are made to protect the 140,000 Iowans who will suffer if this draft moves forward in its current form.

Thank you,

Cheryl Plank                                                       Christina Schark

Tenco Executive Director                              Southern Iowa Mental Health Center Executive Director