About 20 percent of adolescents ages 13-18 have a mental health problem, yet only 40 percent of those get help. The average time it takes to seek help is eight to 10 years. And 1 in 12 high school students attempt suicide, making it the third-leading cause of death for 10- to 24-year-olds, according to a recent study by the Centers for Disease Control and Prevention. Almost 160,000 youth ages 10-24 receive medical care for self-inflicted injuries at emergency departments across the U.S.
These dreadful numbers will only rise if the American Health Care Act that was recently passed by the U.S. House of Representatives, or anything like it, gets approved by the U.S. Senate and enacted into law.
If the AHCA is passed, basic protections for children and youth with pre-existing conditions, including mental illness and addictions, will be eliminated. The federal requirement that mental health be included by insurers as an essential benefit will be removed.
Federal parity law requires health insurance issuers to make sure that essential health benefits such as copays and deductibles, as well as visit limits, apply equally to mental health and substance abuse treatment and to other medical benefits. In contrast, the AHCA allows states to waive certain federal protections, such as essential health benefits, which means that they would have the option to eliminate mental health parity and addiction equity in exchange plans.
The $880 billion in federal Medicaid cuts included in the AHCA will lead to an enormous reduction in mental health coverage for millions of families. Although only five percent of children ages 5-18 are uninsured, if a bill like this passes the U.S. Senate, it would be a setback for the goal of universal health care for our children – despite the fact that safety-net programs like Medicaid were created specifically to protect all vulnerable citizens.
House Speaker Paul Ryan referred to the repeal of the Affordable Care Act as an “act of mercy.” In response, U.S. Rep. Joseph Kennedy of Massachusetts said turning a cold shoulder to the mentally ill is not an “act of mercy.” It is an “act of malice.”
Passing the AHCA would mean more community-based children’s mental health agencies will close or have to significantly restrict access to care or dilute services to balance their budgets. When those organizations emphasize cost management over care, more families struggling with mental illness or addiction could find their children in emergency rooms, costly institutional settings, on the street, in jail, or worse.
The looming threat of a national health insurance policy that strips away parity and equity for mental health and substance abuse is an attack on us all. It discriminates against the most vulnerable and is a clear denial of civil rights.
Treatment is the most effective way to help.Treatment requires insurance coverage, just like any other health problem. Limiting access to care compounds the public health challenges of mental illness and addiction. The answer is not Obamacare or Trumpcare; we need bipartisan care that is affordable, effective and accessible.
Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children and their families.