By Jessica Gehr

In a speech to state human services agencies last week, U.S Health and Human Services (HHS) Secretary Tom Price outlined three priorities for his department: childhood obesity, opioid addiction, and mental health. Ironically, at the same time that Secretary Price is promoting these priorities; his former colleagues in Congress are setting these efforts up to fail. Medicaid, which provides over 97 million people with affordable comprehensive health care, is a critical part of the solution for each of Secretary Price’s priorities. Efforts through the American Health Care Act (AHCA) or other means to change the structure of Medicaid to a block grant or per-capita cap would jeopardize the ability of HHS to combat these pressing health issues. Secretary Price’s support for these fundamental changes to Medicaid directly contradicts his statement of priorities.

Childhood Obesity

Insured children are generally healthier and more likely to get necessary treatment and preventive care than those who don’t have coverage. Affordable health insurance is integral to children getting the care they need. Medicaid’s existing Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) coverage provides comprehensive obesity-related health care interventions—and states can build on this existing program to encourage and support intervention activities. Childhood obesity has a profoundly disparate impact on poor and minority youth, so addressing obesity is critical to health equity as well. Proposed changes to Medicaid under the AHCA would eliminate the requirement for states to provide EPSDT coverage, resulting in millions of children facing significant difficulties in accessing and affording the breadth of services they need.

Opioid Addiction

Medicaid has been at the forefront of fighting the opioid epidemic that contributed to approximately 29,000 deaths in 2014 alone. Medicaid plays a crucial role in covering people who are struggling with addiction and helping states provide access to early intervention and treatment. One study found that expanding Medicaid reduced the unmet need for substance use treatment by 18.3 percent. Under its current structure, Medicaid has been able to respond quickly to the opioid epidemic; however, proposed changes to Medicaid could put substance use disorder treatment benefits at risk.

Mental Health

Medicaid is the largest payer for mental health services in the country, covering 20 percent of adults with mental illness and 24 percent of adults with serious mental illness. The Affordable Care Act’s (ACA) Medicaid expansion has been particularly helpful to low-income young adults who rarely had access to affordable, quality health insurance before the ACA. Thanks to the Medicaid expansion, people are getting the mental health coverage, counseling, treatment, and medications they need. The number of low- and middle-income people who have foregone mental health or substance use disorder care due to the cost has dropped by one-third. This is particularly important for addressing maternal depression, a widespread public health problem that affects millions, including poor mothers, and has lasting implications for children. Changes to Medicaid in the AHCA would threaten the ability of low-income people to get the mental health services they need to be healthy and to find and keep work.

AHCA would deeply harm people receiving Medicaid

The AHCA puts health insurance coverage at risk for millions of people, shifts costs to states and then on to sicker and older populations, and jeopardizes access to care for millions of adults and children on Medicaid. Under the AHCA, Medicaid’s financing structure would be changed from a federal-state partnership to a block grant or per-capita cap. States would be left holding the bag alone to fight for Secretary Price’s priorities. A growing body of research demonstrates that Medicaid lifts people out of poverty, keeps people healthy, improves children’s wellbeing, promotes work and financial stability, and increases economic activity and job growth. Unfortunately, the AHCA takes a giant step backward on Medicaid and risks coverage for millions of people. If Secretary Price is serious about addressing childhood obesity, the opioid epidemic, mental health, and other pressing issues, he should reject such cuts to Medicaid.