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Fact Sheet: Impact of S. 1932, the Budget Reconciliation Bill
on Access to Mental Health Services
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MEDICAID AND MENTAL ILLNESS:
Mental illness is the leading cause of disability and premature death in this
country. Medicaid provides a lifeline for millions of Americans who need mental
health care. By covering a broad range of critical services—services not
covered or only minimally covered by private insurance—Medicaid enables people
with mental illness to recover in their homes and communities, instead of being
placed in costly and often less effective institutions.
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On Wednesday February 1, 2006,
the House of Representatives will vote on final passage of S. 1932, the Budget
Reconciliation Bill, that would cut Medicaid services by $42 billion over 10
years and dramatically reduce the accessibility of community-based mental
health care—resulting in people becoming sicker, needing emergency care and
hospitalization--ultimately costing the Federal Treasury and States more in
the long run.
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THE BILL WOULD CUT CURRENT
MEDICAID SERVICES: Some of the bill’s
supporters have attempted to defend the legislation by focusing attention on the
overall or “aggregate” effect of the bill, which is to slow the long-term growth
in Medicaid spending. But entitlement programs like Medicaid grow each year
because the U.S. population continues to grow and the services they deliver cost more.
S. 1932 would “reduce the growth” by dramatically cutting back currently
provided Medicaid services and imposing prohibitive fees on low-income Americans.
In particular:
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S. 1932 would allow States to
increase cost-sharing for Medicaid services – even for beneficiaries with
incomes below the poverty level – and to charge premiums for the first time.
Such copayment increases and premiums would reduce
access to care for the poorest and sickest Americans.
We have already seen this month, with the transition of people from Medicaid to
the new Medicare Part D drug program, that new or increased copayments for drugs
or services cause people with mental illness to suffer relapses and end up in
costly hospitals. The increases in co-payments for health care
services would be especially large for people just above the poverty line, who
could find themselves charged $20 to $100 or more for some health care services
for which they now are charged no more than $3.
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S. 1932 would allow states to
remodel their Medicaid benefits in a way that would dramatically reduce
access to services that are currently available to poor children only through
Medicaid’s Early and Periodic, Screening, Diagnosis and Treatment (EPSDT).
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S. 1932 would allow
states to require higher cost sharing for non-preferred (i.e. non-formulary)
medications. This ignores the complexity that mental health medications are not
clinically interchangeable and can have significantly different effects on
different individuals. This would happen at the same time that many mental
health consumers are struggling with the fiasco of interrupted coverage due to
the transition to Medicare Part
D.
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S. 1932 would cut three-quarters of
a billion dollars out of targeted case management (TCM) services, which
are extremely important in providing adults and children with mental illness
access to the complex array of community-based medical services and supports
that are vital to home-based recovery. Without these community-based services,
people with mental disabilities will end up in costly institutions.
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This budget reconciliation
legislation will not reduce the federal deficit. This bill – together
with the other 2006 budget reconciliation bill to be voted on later in February
– increase the federal deficit because of new tax cuts.
CALL YOUR MEMBER OF CONGRESS AT
202-224-3121 ON JANUARY 31, 2006 – NATIONAL MENTAL HEALTH “CALL CONGRESS DAY”
– TO DEMAND THAT HE OR SHE VOTE AGAINST S. 1932, THE BUDGET
RECONCILIATION BILL, THAT WOULD CUT BILLIONS OUT OF VITAL MEDICAID SERVICES FOR
AMERICA’S MOST VULNERABLE CITIZENS.
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