On May 3, 2017, NAADAC, the Association for Addiction Professionals, along with 434 other organizations representing consumers, families, providers, health care and social service professionals, advocates, and allies, sent the following letter to Speaker Paul Ryan and Leader Nancy Pelosi to express its opposition to the most recent version of the American Health Care Act (AHCA):

Dear Speaker Ryan and Leader Pelosi,

The undersigned organizations are writing to share our views on the most recent version of the American Health Care Act (AHCA). We are very concerned that the AHCA’s proposed changes to our health care system will result in reductions in health care coverage, particularly for vulnerable populations including those suffering from substance use disorders and mental illness, and we continue to be unable to support the bill in its current form.

We collectively represent consumers, families, providers, health care and social service professionals, advocates and allied organizations who are committed to meaningful and comprehensive policies to reduce the toll of substance use disorders and mental illness through prevention, treatment and recovery support services.

More than 20 million Americans currently have health care coverage due to the Affordable Care Act (ACA), including millions of Americans with substance use disorders and mental illness. This coverage is a critical lifeline for these individuals, many of whom were unable to access effective treatment before the ACA’s expansion of Medicaid eligibility to low-income adults, and its requirement that Medicaid expansion plans and plans sold in the individual and small group markets provide essential health benefits (EHB) including substance use disorder and mental health treatment services at parity with medical and surgical services.

In the face of the opioid overdose and suicide epidemics, equitable access to a full continuum of mental health and substance use disorder treatment services, including medications to treat substance use disorders and mental illness, must be an essential component of health care coverage. It is also critical that substance use disorders and mental illness be covered on par with other medical conditions consistent with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The Affordable Care Act (ACA) extended the applicability of MHPAEA to the small and individual group market as well as Medicaid expansion plans, which are currently required to offer substance use disorder and mental health services at parity with medical and surgical services. As authors writing in the New England Journal of Medicine recently noted, “Repeal of the ACA would dismantle these protections and turn the clock back to a time when most Americans were subject to restrictive and inequitable limits on coverage for medication treatment and other supplementary treatments for opioid use disorder.”

We remain concerned that provisions in the bill to roll back the Medicaid expansion, allow states to receive waivers from EHB requirements for private plans, sunset the EHB requirements for Medicaid expansion plans, and cap federal support for Medicaid beneficiaries will reduce coverage for and access to substance use disorder and mental health treatment services. The amendment being proposed by Representatives Upton and Long to provide funds to offset the costs of individuals with pre-existing conditions who cannot afford health insurance coverage does not address our serious concerns about these provisions in the AHCA that would reduce access to life saving substance use disorder and mental health treatment.

The Medicaid expansion in particular has led to significant increases in coverage and treatment access for persons with addiction and mental illness. In states that expanded Medicaid, the share of people with substance use disorders or mental illness who were hospitalized but uninsured fell from about 20 percent in 2013 to 5 percent by mid-2015, and Medicaid expansion has been associated with an 18.3 percent reduction in unmet need for addiction treatment services among low-income adults. Rolling back the Medicaid expansion and fundamentally changing Medicaid’s financing structure to cap spending on health care services will certainly reduce access to evidence-based treatments and reverse much or all progress made on the opioid crisis last year. Moreover, the loss of Medicaid-covered mental health and substance use disorder services for adults would result in more family disruption and out-of-home placements for children, significant trauma which has its own long-term health effects and a further burden on a child welfare system that is struggling to meet the current demand for foster home capacity.

Medicaid funding for mental health and substance use disorder treatment services for low-income populations must be predictable, sustainable, and integrated with financing mechanisms for general medical care to ensure consistent access to treatment and support the long-term development and retention of an addiction and mental health clinician workforce.

The ACA’s Medicaid expansion, EHB requirements for mental health and substance use disorder treatment coverage, and extension of parity protections to the individual and small group market have surely reduced the burden of the opioid misuse and overdose and suicide epidemics and saved lives. As you consider this legislation, we ask that you ensure substance use disorder and mental health treatment benefits continue to be available to Americans enrolled in the individual, small and large group markets as well as Medicaid plans and that these benefits are compliant with the Mental Health Parity and Addiction Equity Act.

Finally, throughout this process, we implore you to keep in mind how your decisions will affect the millions of Americans suffering from substance use disorders and mental illness who may lose their health care coverage entirely or see reductions in benefits that impede access to needed treatment.


1. Acadia Healthcare

2. Adcare Educational Institute

3. Addiction Education Society

4. Addiction Haven

5. Addiction Resource Council

6. Addiction Services Council

7. Addiction Policy Forum

8. Addiction Treatment Center of New England

9. Addictions Connections Resource

10. Advocates for Recovery Colorado

11. Advocates, Inc.

12. Alabama Society of Addiction Medicine

13. Alano Club of Portland

14. Alcohol & Addictions Resource Center

15. Alcohol/Drug Council of North Carolina

16. Alternatives Unlimited, Inc.

17. Amesbury Psychological Center, Inc.

18. American Correctional Association

19. American Federation of State, County and Municipal, Employees (AFSCME)

20. American Academy of Addiction Psychiatry

21. American Academy of Pediatrics

22. American Association for Marriage and Family Therapy

23. American Association for the Treatment of Opioid Dependence (AATOD)

24. American Association of Child & Adolescent Psychiatry

25. American Association on Health and Disability

26. American Congress of Obstetricians and Gynecologists

27. American Dance Therapy Association

28. American Foundation for Suicide Prevention

29. American Group Psychotherapy Association

30. American Medical Student Association

31. American Mental Health Counselors Association

32. American Nurses Association

33. American Public Health Association

34. American Psychiatric Association

35. American Psychological Association

36. American Society of Addiction Medicine

37. A New PATH

38. Anxiety and Depression Association of America

39. Arc of South Norfolk, The

40. Arise & Flourish

41. Arizona’s Children Association

42. Arizona Council of Human Service Providers

43. Arizona Society of Addiction Medicine

44. Arkansas Society of Addiction Medicine

45. Association for Ambulatory Behavioral Healthcare

46. Association for Behavioral Healthcare of Massachusetts

47. Association for Community Affiliated Plans

48. Association for Community Human Service Agencies

49. Association of Asian Pacific Community Health Organizations (AAPCHO)

50. Association of Flight Attendants – CWA, AFL-CIO

51. Association of Persons Affected by Addiction (APAA)

52. Association of Recovery Schools

53. Association of Recovery Community Organizations

54. Association of Women’s Health, Obstetric and Neonatal Nurses

55. A Stepping Stone to Success

56. Atlantic Prevention Resources, Inc.

57. Avanti Wellness


59. Bangor Area Recovery Network, Inc.

60. Bay Cove Human Services

61. Bay State Community Services, Inc.

62. Bazelon Center for Mental Health Law

63. Behavioral Health Network, Inc.

64. Better Life in Recovery

65. Bill Wilson Center

66. Boston Alcohol and Substance Abuse Programs, Inc.

67. Boston Healthcare for the Homeless

68. Boston Public Health Commission

69. BreakingTheCycles

70. Bridge of Central Massachusetts, Inc., The

71. Bridgewell

72. Brien Center for Mental Health and Substance Abuse Services, The

73. Brookline Community Mental Health Center

74. Bullhook Community Health Center, Inc.

75. Burke Recovery

76. California Consortium of Addiction Programs & Professionals

77. California Council of Community Behavioral Health Agencies

78. California Society of Addiction Medicine

79. Cambridge Health Alliance

80. Camelot Care Centers, Inc.

81. Cape Cod Healthcare Centers for Behavioral Health

82. Capital Area Project Vox

83. Casa Esperanza

84. Casa Pacifica Centers for Children and Families

85. Catholic Charities Family Counseling and Guidance Center

86. Catholic Family Center

87. Center for Human Development

88. Center for Open Recovery

89. Center for Recovery and Wellness Resources

90. Central City Concern

91. Chautauqua Alcoholism and Substance Abuse Council

92. Chicago Recovering Communities Coalition (CRCC)

93. Child & Family Services, Inc.

94. Child and Family Services of New Hampshire

95. Children’s Friend, Inc.

96. Children’s Home Society of Washington

97. Children’s Law Center

98. Children’s Services of Roxbury

99. CleanSlate

100. Clergy for a New Drug Policy

101. Clinical and Support Options, Inc.

102. Clinical Social Work Association

103. Coalition of Addiction Students and Professionals Pursuing Advocacy (CASPPA)

104. Colorado Society of Addiction Medicine

105. Community Catalyst

106. Communities for Recovery

107. Community Anti-Drug Coalitions of America (CADCA)

108. Community Counseling of Bristol County, Inc.

109. Community-Minded Enterprises

110. Community Oriented Correctional Health Services (COCHS)

111. Community Services Institute

112. Community Solutions

113. Community Substance Abuse Centers

114. Connecticut Community for Addiction Recovery (CCAR)

115. Connecticut Society of Addiction Medicine

116. Counselors Obediently Preventing Substance Abuse (COPS)

117. Cutchins Programs for Children and Families

118. DarJune Recovery Support Services & Café

119. Dash for Recovery

120. Davis Direction Foundation - The Zone

121. DC Fights Back

122. DC Recovery Community Alliance

123. Delphi Behavioral Health Group/MHD

124. Desert Eagle Addiction Recovery

125. Detroit Recovery Project, Inc.

126. Dimock Community Health Center

127. Disability Rights Pennsylvania

128. Doctors for Recovery

129. Dorchester Recovery Initiative

130. Drug and Alcohol Service Providers Organization of Pennsylvania (DASPOP)

131. Drug Policy Alliance

132. Drug Prevention Resources

133. East Bay Agency for Children

134. Easy Does It, Inc.

135. Eating Disorders Coalition

136. Edinburg Center, The

137. Eliot Community Human Services

138. El Paso Alliance

139. Engaged Recovery Community Services

140. Faces and Voices of Recovery

141. Facing Addiction

142. Family Focused Treatment Association

143. Family Service Association

144. Family Service of Greater Boston

145. FAVOR Greenville

146. FAVOR Low Country

147. FAVOR Mississippi Recovery Advocacy Project

148. FAVOR Pee Dee

149. FAVOR Tri-County

150. FED UP! Coalition

151. Fellowship Foundation Recovery Community Organization

152. Fenway Health

153. FHR

154. Florida Society of Addiction Medicine

155. Floridians for Recovery

156. Foundation for Recovery

157. Friends of Recovery - New York

158. FSA – Family Service Agency

159. Futures of Palm Beach

160. G III Associates


162. Gandara Center

163. Georgia Council on Substance Abuse

164. Georgia Society of Addiction Medicine

165. Global Alliance for Behavioral Health and Social Justice

166. Gosnold on Cape Cod

167. Granite Pathways

168. Greater Macomb Project Vox

169. Greater Philadelphia Association for Recovery Education

170. Great South Bay Coalition

171. Greater Cincinnati Recovery Resource Collaborative (GCRRC)

172. Griffin Recovery Enterprises

173. Harm Reduction Coalition

174. High Point Treatment Center

175. Hillview Mental Health Center, Inc.

176. HIV Medicine Association

177. Home for Little Wanderers, The

178. HOPE for New Hampshire Recovery

179. Hope House Addiction Services

180. Horizon Health Services

181. IC&RC

182. Illinois Association for Behavioral Health

183. Illinois Association of Rehabilitation Facilities (IARF)

184. Indiana Society of Addiction Medicine

185. International Nurses Society on Addictions

186. Institute for Health and Recovery

187. Iowa Association of Community Providers

188. Iowa Behavioral Health Association

189. Italian Home for Children, Inc.

190. Jackson Area Recovery Community

191. Jewish Family and Children’s Services (JF&CS)

192. Joint Coalition on Health

193. Jordan's Hope for Recovery

194. Judge Baker Children’s Center

195. Juneau Recovery Community

196. Justice Resource Institute (JRI)

197. Kentucky Society of Addiction Medicine

198. KEY Program, Inc., The

199. Kyes 2 a 2nd Chance

200. Lahey Health Behavioral Services

201. Lakeshore Foundation

202. Latah Recovery Center

203. Legal Action Center

204. Lifehouse Recovery Connection

205. Lifeline Connections

206. Long Island Council on Alcoholism and Drug Dependence, Inc.

207. Long Island Recovery Association (LIRA)

208. Lost Dreams Awaken Center, Inc.

209. Lotus Peer Recovery/SoberKerrville

210. Lowell Community Health Center, Inc.

211. Lowell House, Inc.

212. LUK, Inc.

213. Madison County Council on Alcoholism & Substance Abuse

214. Magnolia Addiction Support

215. Maine Alliance for Addiction Recovery

216. Mariah’s Mission Fund of the Mid-Shor Community Foundation

217. Mark Garwood SHARE Foundation

218. Martha’s Vineyard Community Services

219. Maryland-DC Society of Addiction Medicine

220. Maryland House Detox

221. Maryland Recovery Organization Connecting Communities (M-ROCC)

222. Massachusetts Organization for Addiction Recovery (MOAR)

223. Massachusetts Society of Addiction Medicine

224. McShin Foundation

225. Mental Health Association

226. Message Carriers of Pennsylvania, Inc.

227. Messengers of Recovery Awareness

228. MHA of Greater Lowell

229. Michigan's Children

230. Michigan Recovery Voices

231. Michigan Society of Addiction Medicine

232. Middlesex Human Service Agency, Inc

233. Mid-Michigan Recovery Services, Inc.

234. Midwest Society of Addiction Medicine

235. Mi-HOPE - Michigan Heroin & Opiate Prevention and Education

236. Minnesota Association of Community Mental Health Programs (MACMHP)

237. Minnesota Recovery Connection

238. Minnesota Society of Addiction Medicine

239. Missouri Recovery Network

240. MOBER

241. Mountain View Prevention Services, Inc.

242. NAADAC – the Association for Addiction Professionals

243. National Alliance for Medication-Assisted Recovery (NAMA)

244. National Alliance on Mental Illness

245. National Alliance on Mental Illness – San Mateo County

246. National Alliance to Advance Adolescent Health

247. National Alliance to End Homelessness

248. National Association for Rural Mental Health

249. National Association of Addiction Treatment Providers

250. National Association of Clinical Nurse Specialists

251. National Association of Pediatric Nurse Practitioners

252. National Association of State Mental Health Program Directors (NASMHPD)

253. National Association for Children’s Behavioral Health

254. National Association for Rural Mental Health

255. National Association of Drug Court Professionals

256. National Association of Social Workers (NASW)

257. National Association of County Behavioral Health and Developmental Disability Directors

258. National Council for Behavioral Health

259. National Center on Addiction and Substance Abuse

260. National Council on Alcoholism and Drug Dependence

261. National Council on Alcoholism and Drug Dependence of E. San Gabriel & Pomona Valleys

262. National Council on Alcoholism and Drug Dependence--Greater Phoenix

263. National Council on Alcoholism and Drug Dependence – Maryland

264. National Council on Alcoholism and Drug Dependence – San Diego

265. National Council on Alcoholism and Drug Dependence of the San Fernando Valley

266. National Council on Alcoholism and Drug Abuse-St. Louis Area

267. National Disability Rights Network

268. National Federation of Families for Children’s Mental Health

269. National Health Care for the Homeless Council

270. National League for Nursing

271. National Safety Council

272. Navigate Recovery Gwinnett

273. Nevada Society of Addiction Medicine

274. New Jersey Association of Mental Health and Addiction Agencies, Inc.

275. New Jersey Society of Addiction Medicine

276. New Life Counseling & Wellness Center, Inc.

277. New Mexico Society of Addiction Medicine

278. New York Association of Psychiatric Rehabilitation Services

279. New York Society of Addiction Medicine

280. New York State Council for Behavioral Health

281. NFI Massachusetts, Inc.

282. NMSAS Recovery Center

283. No Health without Mental Health

284. North Charles, Inc.

285. North Cottage Program, Inc.

286. Northeast Center for Youth and Families, The

287. Northern New England Society of Addiction Medicine

288. Northern Ohio Recovery Association (NORA)

289. Northwest Indian Treatment Center

290. North Suffolk Mental Health Association, Inc.

291. Northern Rivers Family Services

292. North Carolina Society of Addiction Medicine (NCSAM)

293. O’Brien House

294. Ohio Society of Addiction Medicine (OHSAM)

295. Oklahoma Citizen Advocates for Recovery & Treatment Association (OCARTA)

296. Old Colony YMCA

297. Open Doorway of Cape Cod

298. Oregon Recovery High School

299. Oregon Society of Addiction Medicine

300. Overcoming Addiction Radio

301. Parity Implementation Coalition

302. Partnership for Drug-Free Kids

303. Partners in Prevention/National Council on Alcoholism and Drug Dependence of Hudson County, Inc.

304. P.E.E.R Wellness Center, Inc.

305. PEER360 Recovery Alliance

306. Pennsylvania Recovery Organization - Achieving Community Together - (PRO-ACT)

307. Pennsylvania Recovery Organizations Alliance (PRO-A)

308. Pennsylvania Society of Addiction Medicine

309. People Advocating Recovery - PAR

310. Phoenix Houses of New England

311. Phoenix Multisport Boston

312. Pine Street Inn

313. Pivot, Alcohol and Substance Abuse Council of Jefferson County, Inc.

314. PLR Athens

315. Pretrial Justice Institute

316. Prevention Network OCAA

317. Psychiatric Rehabilitation Association

318. Putnam Family & Community Services, Inc.

319. RASE Project

320. REAL- Michigan (Recovery, Education, Advocacy & Leadership)

321. Recover Project/Western MA Training

322. Recovery Allies Of West Michigan

323. RecoveryATX

324. Recovery Café Seattle

325. Recovery Community Foundation of Forsyth

326. Recovery Communities of North Carolina

327. Recovery Community Of Durham

328. Recovery Consultants of Atlanta

329. Recovery Data Solutions

330. Recovery - Friendly Taos County

331. Recovery Idaho, Inc.

332. Recovery is Happening

333. RecoveryNC (Governors Institute on Substance Abuse)

334. Recovery Point at HER Place

335. Recovery Point of Bluefield

336. Recovery Point of Charleston

337. Recovery Point of Huntington

338. Recovery Point of Parkersburg

339. Recovery Point of West Virginia

340. Recover Wyoming

341. reGROUP

342. Rhode Island Communities for Addiction Recovery Efforts (RICAREs)

343. Riverside Community Care

344. Robby’s Voice

345. ROCovery Fitness

346. Rockland Council on Alcoholism and Other Drug Dependence, Inc.

347. Sandusky Artisans Recovery Community Center

348. Sandy Hook Promise

349. Serenity Sistas

350. ServiceNet

351. Shatterproof

352. SMART Recovery

353. Solano Recovery Project

354. Solutions Recovery, Inc.

355. Sonoran Prevention Works

356. South Arkansas Regional Health Center, Inc

357. Sound Community Services, Inc.

358. South Middlesex Opportunity Council, Inc. (SMOC)

359. South Bay Community Services

360. South Carolina Society of Addiction Medicine

361. South Central Human Relations Center

362. South End Community Health Center

363. South Shore Mental Health

364. Southwest Washington Recovery Coalition

365. Spectrum Health Systems, Inc.

366. SpiritWorks Foundation

367. Springfield Recovery Community Center

368. Springs Recovery Connection

369. SSTAR

370. STEP Industries

371. Steppingstone, Incorporated

372. Student Assistance Services Corp

373. Substance Use and Mental Health Leadership Council of Rhode Island

374. Technical Assistance Collaborative, Inc.

375. Tennessee Society of Addiction Medicine

376. Texas Society of Addiction Medicine

377. The Addict’s Parents United (TAP United)

378. The Alliance

379. The Bridge Foundation

380. The Bridge Way School

381. The Campaign for Trauma-Informed Policy and Practice

382. The Chris Atwood Foundation

383. The Council on Alcohol and Drug Abuse

384. The Council on Alcohol & Drug Abuse for Greater New Orleans

385. The DOOR - DeKalb Open Opportunity for Recovery

386. The Global Alliance for Behavioral Health and Social Justice

387. The Kennedy Forum

388. The Ohana Center

389. The Recovery Channel

390. The Rest of Your Life

391. The Trevor Project

392. The Village Family Services

393. The Village Project, Inc.

394. Tia Hart Recovery Community Program

395. T.O.R.C.H Inc.

396. Toward Independent Living and Learning, TILL, Inc.

397. Treatment Communities of America

398. Trilogy Recovery Community

399. Two Guys and a Girl

400. UMass Memorial Community Healthlink, Inc.

401. United Methodist Church - General Board of Church and Society

402. Utah Support Advocates for Recovery Awareness (USARA)

403. Valley Hope

404. Veterans Inc.

405. Vermont Council of Developmental and Mental Health Services

406. Vermont Recovery Network

407. Victory Programs, Inc.

408. Vinfen

409. Virginia Association of Recovery Residences

410. Voice for Adoption

411. Voices of Hope for Cecil County

412. Voices of Recovery San Mateo County

413. Volunteers of America of Massachusetts, Inc.

414. WAI-IAM, Inc. and RISE Recovery Community

415. Walker, Inc.

416. Washtenaw Recovery Advocacy Project (WRAP)

417. Washington Federation of State Employees

418. Washington Recovery Alliance

419. Washington Society of Addiction Medicine

420. Watershed Treatment Programs

421. Wayside Youth & Family Support Network

422. WEConnect

423. Wellspring Recovery Services

424. West Virginia Society of Addiction Medicine

425. WholeLife Recovery Community/ Arizona Recovery Coalition

426. Wisconsin Recovery Community Organization (WIRCO)

427. Wisconsin Society of Addiction Medicine

428. Wisconsin Voices for Recovery

429. Wyoming County CARES

430. Yoga of Recovery

431. Young Invincibles

432. Young People in Recovery

433. Young People in Recovery – Los Angeles

434. Youth Opportunities Upheld, Inc.

435. Youth Villages

Media Contact
Jessica Gleason
703.741.7686 x 130

NAADAC, the Association for Addiction Professionals, represents the professional interests of more than 95,000 addiction counselors, educators and other addiction-focused healthcare professionals in the United States, Canada, and abroad. NAADAC’s members are addiction counselors, educators, and other addiction-focused health care professionals, who specialize in addiction prevention, treatment, recovery support, and education. An important part of the healthcare continuum, NAADAC members, and its 47 state affiliates work to create healthier individuals, families and communities through prevention, intervention, quality treatment and recovery support.

Share |