1 in 3 Americans is affected by addiction or mental illness: We need a plan to protect their care

Getty Images

As policymakers evaluate recently proposed legislation to modify the Affordable Care Act, one issue may stand out for its bipartisan support. The need to address mental health and substance use disorders in any “repeal and replace” proposal is of paramount concern to many leaders on both sides of the political aisle.  The reasons for that bipartisan support are painfully clear.

Every single day, over 266 Americans will die from either a drug overdose or suicide. Substance use disorders and mental illness affect 1 out of every 3 adults in this country. Untreated mental health and substance use problems can be devastating and costly – for individuals, families, communities and society as a whole. The health of our Nation depends on improving Americans’ mental health and reducing addictions.

{mosads}Unlike many challenges that face our Nation, there is strong bipartisan commitment to continue strengthening mental health and substance use prevention, treatment services and medications, rehabilitation, and recovery support services.  Over the past decade, Congress has enacted and Presidents have signed a series of important reforms, including the Mental Health Parity and Addiction Equity Act, various provisions of the Affordable Care Act, the Comprehensive Addiction and Recovery Act, and the 21st Century Cures Act. Together, these laws established a very important new framework that, for the first time in our Nation’s history, addresses mental health and substance use disorders on a par equal to physical illnesses.

Today, more Americans than ever before have access to the full continuum of life-saving care options for mental health and substance use problems.  The challenge now is how to build on this progress.

Amidst all the uncertainty and rancor swirling around the healthcare debate, our Nation cannot afford to backtrack on its efforts to help many more of the 1 in 3 among us living with substance use disorders and/or mental illness.  From the campaign trail, Donald Trump spoke passionately about the need to do more, saying “[i]t is tragedy enough that so many Americans are struggling with life-threatening addiction. We should not compound that tragedy with government policies and bureaucratic rules that make it even harder for them to get help.”  

Now is the time to turn that passion into a real plan of action.

To that end, the Coalition for Whole Health, a group representing national organizations focused on mental health and substance use, has sent comprehensive recommendations to the administration and the 115th Congress, urging them to ensure that all healthcare policy proposals include several key elements.

First and foremost, we urge policymakers to maintain current legal requirements that the full range of mental health and substance use disorder services and medications are covered at parity with other health benefits in all private insurance and Medicaid coverage.

Coverage is essential to treatment. And Medicaid expansion has been a critical element of improving access to treatment. Approximately 29 percent of people covered by the expansion are living with a mental illness or substance use disorder.  We urge policymakers to not only maintain current Medicaid coverage but also reject proposals to shift it to a block grant or impose per capita caps that would cripple the ability of states to respond to the opioid epidemic and other mental and substance use disorders. 

For the millions of Americans covered by private insurance, premium and cost-sharing assistance should be maintained so that people not only can afford to remain insured but also can access quality MH and SUD services.

But coverage alone is not enough. Insurers must continue to be required to have adequate networks of mental health and substance use care providers.  And protections for people with pre-existing conditions must be maintained.

The twin epidemics of opioid addiction and suicide deaths have created an enormous public health emergency.  But they have also galvanized a strong, bipartisan commitment to expand and improve our Nation’s health responses to mental health and substance use disorders.  Now is the time for policymakers to translate that commitment into policy. Done right, it will not only save countless lives, but also hundreds of billions of dollars.  Surely, that is an investment we all can support. 

Ron Manderscheid and Paul Samuels are Co-Chairs of the Coalition for Whole Health, which brings together leading national organizations to advocate for policies to increase access to quality mental health and substance use care. 

The views expressed by this author are their own and are not the views of The Hill.

Tags Donald Trump

The Hill has removed its comment section, as there are many other forums for readers to participate in the conversation. We invite you to join the discussion on Facebook and Twitter.

See all Hill.TV See all Video

Most Popular

Load more


See all Video