Why we can’t let the GOP upend a key part of McCain’s legacy

Why we can’t let the GOP upend a key part of McCain’s legacy
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Today, we laid to rest arguably one of our country’s most notable war heroes, Sen. John McCainJohn Sidney McCainBiden and Schumer face battles with left if Democrats win big Trump digs in on conspiracy theory over bin Laden raid At 97, Bob Dole is still fighting for his country MORE (R-Ariz.). The past week has been filled with a number of moving tributes and in-depth coverage of his legacy on the battlefield and on the Senate floor.

While our political views differed in many areas, I gained a new level of respect for Sen. McCain the night he saved ObamaCare with a simple thumbs down. It is a gesture that now serves as a bookend for his Senate career and one that saved the health coverage for millions of Americans, particularly those with mental health and substance use challenges.  


While the rest of the country pauses to honor his legacy, many on Capitol Hill are already focused on undoing it by urging the governor of Arizona to appoint a senator to McCain’s seat who they can trust will repeal ObamaCare. While we are having no shortage of political issues that we need to mobilize behind, I urge mental health advocates to keep up the fight against those looking to strip away care that took more than a century and a half to obtain.  

Contrary to how it’s viewed, mental health is not a fringe issue. An estimated 44 million Americans experience mental health conditions every year and approximately 350,000 people die prematurely from mental illness and substance use.

Furthermore, one in two individuals will be diagnosed with a mental illness or disorder in their lifetime, suicides are rising across the United States, opioid overdoses are the leading cause of death for people under 50 (one in five individuals struggling with opioid addiction can’t get behavioral health services and treatments) and depression is projected to be the leading cause of disability in the next 20 years. The economic burden to the United States for failing to adequately address this issue each year is a staggering $467 billion.

The passage of ObamaCare marked the first time in American history that federal law mandated that mental health and substance use disorder benefits should be an essential health benefit along with rehabilitative, habilitative, and prevention and wellness coverage.

It expanded parity protections, promoted the integration of behavioral health and primary care within delivery and payment system reforms, prioritized depression and substance use screenings as preventive services at no cost to the consumer, and provided other opportunities for behavioral health prioritization.

This coverage victory was the result of a hard fought battle that started more than a century and a half before ObamaCare was passed. Dorothea Dix, teacher, activist and humanitarian, began a movement to advocate for health reforms to address the issues surrounding those with mental health challenges in the early 1800s. She spent years lobbying state legislatures to provide adequate institutions for treatment and care, until she determined it was only the federal government that could effectively carry this national crusade.

Dix’s initiative eventually landed on President Franklin Pierce’s desk in 1854 where it was vetoed. And so the federal role in mental health care — extremely limited federal participation or non-participation — stood for a century until administrations starting in 1942 began enacting piecemeal legislation on mental health culminating in comprehensive care being granted by the passage of ObamaCare.

We must not go backwards. If the GOP purports to care about the opioid epidemic and Mitch McConnellAddison (Mitch) Mitchell McConnellSenate GOP eyes Oct. 26 for confirming Barrett to Supreme Court GOP noncommittal about vote on potential Trump-Pelosi coronavirus deal Overnight Health Care: Trump takes criticism of Fauci to a new level | GOP Health Committee chairman defends Fauci | Birx confronted Pence about Atlas MORE says they will be considering a bipartisan opioid bill in late September, then it goes without saying that keeping McCain’s legacy of saving ObamaCare is the only way to do this. There is no way that the GOP can be both for helping those with opioid addiction and for repealing ObamaCare.

So, I call on mental health champions and regular Americans to channel the spirit of Dix and others. Definitely take this time to mourn the legacy of John McCain. Then get right to work on stopping those hellbent on upending the gains seen under ObamaCare.

Fight to protect the legacy of a Senator who saw past the pressures of his party to do what is right for the American people. And the legacy of millions of Americans with mental challenges who have benefitted from the Affordable Care Act and millions of others still yearning for that help and support.

If mental health advocates care about achieving equity in behavioral health, then we must speak up and act now. Because if we don’t, I fear that a century from now we'll still be fighting the never-ending battle for a more accessible, equitable and inclusive health system.

Daniel E. Dawes, JD, is the author of “150 Years of Obamacare” and serves as the senior adviser to the Satcher Health Leadership Institute at Morehouse School of Medicine and Associate Professor at Nova Southeastern University. He founded and chaired the National Working Group on Health Disparities and Heal