Deep concerns about impact of Trump’s health care plan on Pa.

By Rep. Mike Schlossberg and Rep. Tom Murt

The discernment by our elected officials in Washington over President Donald Trump’s newly proposed American Health Care Act should be thoughtful and thorough. It should also meticulously consider the impact of this new law on the good people in our commonwealth, especially those suffering a serious mental illness. As members of the Human Services Committee and the Mental Health Subcommittee in Harrisburg, and as advocates for Pennsylvanians who desperately need health care coverage the most, this proposal is a cause for great concern.   

Part of the AHCA calls for the reduction and removal of Medicaid coverage for many Pennsylvanians. In our state, Medicaid provides coverage to 2.8 million working class and lower-income Pennsylvanians which represents 22 percent of our population. Medicaid provides critically important preventive services such as vaccines, well-child visits, and lifesaving treatments for chronic diseases such as cancer, opioid addiction, liver disease and Hepatitis C. 

In Pennsylvania, Medicaid also provides outpatient services to over one-half million of our family members who suffer from a serious mental illness. Medicaid empowers these people to stay with their families and to continue to work and pay taxes, and to avoid incarceration or costly inpatient hospitalization. Perhaps most importantly to us and to the families who care for a loved one with a serious mental illness, we are troubled about removing the supports that help this population remain in their homes and communities. Many of these men and women live independently or semi-independently and also work, pay taxes and are firmly on the road to recovery. 

People living with serious mental illnesses are one of our most vulnerable populations, and in all candor, a population whose needs and care have been underfunded for decades. The lack of adequate funding has already resulted in closures and mergers of community-based services, and diminished proximity of services to people who need them. This is especially true in the most rural parts of Pennsylvania where a person who needs therapy or counseling often has to travel great distances to access the services they need to be well. 

Our commonwealth slightly exceeds the national average of those who seek mental health treatment. As a Medicaid expansion state, the loss or reduction of Medicaid funding for our commonwealth will be nothing short of devastating for our brothers and sisters who suffer from a serious mental illness, and the professionals who compassionately treat them. 

Due to Medicaid expansion in Pennsylvania, over 159,000 new people who suffer from a serious mental illness were enrolled in health care coverage. This means more recovery-oriented treatment, community care, and supports that enable these people to live in the community and lead independent and productive lives. If President Trump’s plan to pull back Medicaid comes to fruition, that will result in less family-based support, outpatient care, partial hospitalization, emergency and crisis intervention, peer to peer support, and after care. It will also mean fewer community residential services including housing support, residential treatment, inpatient care, crisis services and mobile therapy. 

In short, less community treatment options will mean longer delays, missed work, isolation from support networks and missed opportunities to get people on the road to recovery. The lack of mental health services will also surely result in more of these people ending up in prison. Prison is not the optimal place to receive mental health treatment. In Pennsylvania, 29 percent of the prison inmates suffer from a mental illness. Had these man and women received the treatment they needed from the health care system, they may not have ended up in the much more expensive prison system. 

With access to the right care, at the right time, people can and do recover from mental illness. We must preserve access to and adequate funding of Medicaid. The Affordable Care Act is not just about Medicaid. It has also allowed 410,000 Pennsylvanians to access health care coverage through the marketplace. We have only discussed one aspect of the proposed cuts under consideration in Washington. Many other facets of health care face similar challenges including care for intellectual and developmental disabilities, substance use disorders and brain injuries. Unless this new legislative proposal is considered with compassion and a desire to care for the most vulnerable, the health care crisis in Pennsylvania and across the nation could become even more urgent.