If you think that the Republican party's last effort to repeal and replace Obamacare was indeed its very last, you are wrong. In its latest effort to repeal the Affordable Care Act, the GOP has introduced the Graham-Cassidy health care bill which appears to be the antithesis of virtually every stipulation within the ACA. Observers have noted how the bill, if it passes, could hurt millions of Americans in multiple and life-threatening ways. One of the potential effects of the Graham-Cassidy bill is its gutting of mental health services for the most vulnerable people in the United States.
Under the bill's block grant program, each state would be free to decide how it would spend its federal funding. This means that if a state chooses to, it can waive requisites to provide its locals with services and coverage for mental health. A block grant program is a monetary system of governance in which the provision of federal funds — simple money — from the federal government goes to a regional state's governing body. This government is then free to do what it pleases with such funds as long as it abides by certain rules stated in the bill.
It's worth knowing how the bill even came to be. Introduced on September 13 by Republican senators Bill Cassidy of Louisiana and Lindsey Graham of South Carolina, the joint-named Graham-Cassidy bill appears to be the latest Republican attack on the ACA. In bare terms, the bill seeks the elimination of ACA, would take the federal funding from the programs within it, and allot it to individual states who are then allowed to conduct their own method of health care provisions.
If the bill becomes law, states will have the power to exclude essential health benefits, including mental health coverage. The possible ramifications of such waiving isn't new to economists and health care experts who study bills in American politics. Even before the Graham-Cassidy proposal, the Congressional Budget Office took notice of how damaging the consequences would be if states chose to waive ACA provisions.
The CBO noted that if states went forth and removed requisites for mental health services, Americans in desperate need of such coverage "would face increases in their out-of-pocket costs. Some people would have increases of thousands of dollars in a year." States would be allowed to waive requisites for coverage that also include counseling, psychotherapy, and professional help needed to overcome substance abuse.
Allowing states to do what they please sounds preferable to those wary of "too much government" but the risks it would pose to people who need better mental health services are undeniably high. Still, the GOP has been consistently pushing against caution. In July, Sen. Cassidy justified his approach for letting states do as they please by saying, "A blue state can do a blue thing, a red state a red thing."
Autonomy may appear attractive on the surface but critics believe that such carte blanche handed at a state level could lead to life-threatening consequences for Americans seeking health care. Executive director of the American Public Health Association, Georges Benjamin, recently opposed the Graham-Cassidy bill and said that it "would take health insurance coverage away from millions of people, eliminate critical public health funding, devastate the Medicaid program, increase out-of-pocket costs, and weaken or eliminate protections for people living with pre-existing condition."
If the growing amount of pushback against the bill doesn't offer a substantive case against it, you simply need to ask: What would happen to someone with depression (or any mental health issue) seeking professional help in a state that has waived requirements for covering mental health? Neither Sen. Graham nor Sen. Cassidy have provided answers so far.