Executive Order on Healthcare Choice Undermines States and Hurts Mental Health

By Paul Gionfriddo, MHA National President and CEO

Mental Health America applauds governmental leaders who agree that all Americans should have access to affordable, high-quality health care. Today’s Executive Order – “Promoting Healthcare Choice and Competition Across the United States” – falls far short of this goal.

Much of the Executive Order focuses on association health plans (AHPs), short-term, limited-duration insurance (STLDI), and health reimbursement arrangements (HRAs). Because these initiatives will do little or nothing for people with behavioral health conditions and most other Americans, it offers false hope to us – at the high cost of future market instability.

The Executive Order undermines the Constitutional authority of states in the health care space, because it would take away power from the states to regulate these plans and strip key consumer protections, including mental health and substance use services. At the same time, as bargain-shopping consumers are peeled away from more comprehensive plans, insurance prices for people currently receiving mental health and substance use services would skyrocket and the insurance market for comprehensive coverage would fall apart.

This assumes that what the Executive Order attempts is both Constitutional and possible under the existing Affordable Care Act law. Both of these concepts are likely to be tested in the courts, further “kicking the can down the road” and delaying delivery on the President’s increasingly empty campaign promise to make available high-quality, affordable insurance options available to everyone.

At MHA, we believe families should be able to get help when they first need it – Before Stage 4. And we believe as does most of America that families who need mental health or substance use treatment should not have to arbitrarily pay more for health insurance.

All health plans need to continue to provide mental health and substance use benefits. That should be the starting point for any reform of ACA. In addition, states need to be able to protect their citizens, and that should be the position of every state official.

MHA hopes that the Administration will come to see that the Executive Order will not work in this form, and is only delaying the opportunity to do some good things.

In fact, there are two parts of this Executive Order in Section 1(c) that, if implemented well, could become an essential part of the future of American health care: (ii) the Administration must promote meaningful competition in health care, and (iii) it must promote the provision of outcome and price information to consumers at minimal burden to providers.

Let’s focus on these two things, and set the rest aside. MHA stands ready to support the states and the Administration in both.