NAADAC, the Association for Addiction Professionals opposes the "Graham-Cassidy" bill, a renewed effort to repeal and replace the Affordable Care Act (ACA) sponsored by Senators Graham (R-SC) and Cassidy (R-LA). The Graham-Cassidy bill would repeal major provisions of the ACA by ending guaranteed coverage of substance use disorders and mental health services, and cutting Medicaid, a critical lifeline for millions of Americans with substance use disorders and mental illness. The Senate could vote on this bill as early as next week.
Along with 469 groups, NAADAC sent the following letter to Senators Graham, Cassidy, Heller, and Johnson to express its opposition to the bill:
Dear Senator Graham, Senator Cassidy, Senator Heller and Senator Johnson:
The undersigned organizations are writing to share our serious concerns with several of the health system reforms included in the Graham-Cassidy-Heller-Johnson (GCHJ) proposal. We are very concerned that the GCHJ’s proposed changes to our health care system will result in reductions in health care coverage, particularly for individuals with substance use disorders and mental illness, and we cannot support the bill.
We collectively represent consumers, families, providers, health care and social service professionals, criminal justice 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.
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 Mental Health Parity and Addiction Equity Act (MHPAEA).
We recognize that the GCHJ would require coverage of mental health and substance use disorder treatment consistent with MHPAEA as part of the new Medicaid Flexibility Program. However, we do not support many of the other changes to the health care system in the proposal that would result in reduced access to substance use disorder and mental health treatment, including changes that would cap federal funding for Medicaid, end the Medicaid expansion, and eliminate mental health and substance use disorder benefit protections for Americans insured through the small group and individual markets. We have serious concerns with provisions in the proposal that would allow states to easily waive Essential Health Benefit requirements, end Medicaid expansion and change Medicaid to a per-capita or block grant financing system.
The Medicaid expansion in particular has led to significant increases in coverage and treatment access for persons with substance use disorders 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 the unmet need for substance use disorder treatment services among low-income adults.
Rolling back the Medicaid expansion and/or 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. Capping federal Medicaid funding through per-capita caps or block grants would strain state budgets and likely force states to cut benefits, lower provider reimbursement rates, and/or limit access to care. These changes would be devastating to states grappling with the current opioid overdose and suicide epidemics. 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.
The ACA’s Medicaid expansion, Essential Health Benefit 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. Substance use disorder and mental health treatment benefits must 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 Congressional decisions will affect the millions of Americans suffering from substance use disorders and mental illness who may lose
1. 10,000 beds
2. Acadia Healthcare
3. Adcare Educational Institute
4. Addiction Education Society
5. Addiction Haven
6. Addiction Resource Council
7. Addiction Services Council
8. Addiction Policy Forum
9. Addiction Treatment Center of New England
10. Addiction Connections Resource
11. Advocates for Recovery Colorado
12. Advocates, Inc.
13. Alabama Society of Addiction Medicine
14. Alano Club of Portland
15. Alcohol & Addictions Resource Center
16. Alcohol/Drug Council of North Carolina
17. Alliance for Strong Families and Communities
18. Alternatives Unlimited, Inc.
19. Amesbury Psychological Center, Inc.
20. American Correctional Association
21. American Federation of State, County and Municipal, Employees (AFSCME)
22. American Academy of Addiction Psychiatry
23. American Art Therapy Association
24. American Association for Marriage and Family Therapy
25. American Association for the Treatment of Opioid Dependence (AATOD)
26. American Association of Child & Adolescent Psychiatry
27. American Association on Health and Disability
28. American Dance Therapy Association
29. American Foundation for Suicide Prevention
30. American Group Psychotherapy Association
31. American Medical Student Association
32. American Mental Health Counselors Association
33. American Nurses Association
34. American Psychiatric Association
35. American Psychological Association
36. American Society of Addiction Medicine
37. Amida Care
38. A New PATH
39. Anthony's Act
40. Anxiety and Depression Association of America
41. Arc of South Norfolk, The
42. Arise & Flourish
43. Arizona’s Children Association
44. Arizona Council of Human Service Providers
45. Arizona Society of Addiction Medicine
46. Arkansas Society of Addiction Medicine
47. Association for Ambulatory Behavioral Healthcare
48. Association for Behavioral Healthcare of Massachusetts
49. Association for Community Affiliated Plans (ACAP)
50. Association for Community Human Service Agencies
51. Association of Asian Pacific Community Health Organizations (AAPCHO)
52. Association of Community Mental Health Centers of Kansas, Inc.
53. Association of Flight Attendants – CWA, AFL-CIO
54. Association of Persons Affected by Addiction (APAA)
55. Association of Recovery Schools
56. Association of Recovery Community Organizations
57. Association of Women’s Health, Obstetric and Neonatal Nurses
58. A Stepping Stone to Success
59. Atlantic Prevention Resources, Inc.
60. Avanti Wellness
61. Awakening Recovery
63. Bangor Area Recovery Network, Inc.
64. Bay Cove Human Services
65. Bay State Community Services, Inc.
66. Bazelon Center for Mental Health Law
67. Behavioral Health Network, Inc.
68. Better Life in Recovery
69. Bill Wilson Center
70. Boston Alcohol and Substance Abuse Programs, Inc.
71. Boston Healthcare for the Homeless
72. Boston Public Health Commission
74. Bridge of Central Massachusetts, Inc., The
76. Brien Center for Mental Health and Substance Abuse Services, The
77. Brookline Community Mental Health Center
78. Bullhook Community Health Center, Inc.
79. Burke Recovery
80. CADA of Northwest Louisiana
81. California Association of Alcohol and Drug Program Executives (CAADPE)
82. California Consortium of Addiction Programs & Professionals
83. California Council of Community Behavioral Health Agencies
84. California Institute for Behavioral Health Solutions
85. California Society of Addiction Medicine
86. Cambridge Health Alliance
87. Camelot Care Centers, Inc.
88. Cape Cod Healthcare Centers for Behavioral Health
89. Capital Area Project Vox
90. Casa Esperanza
91. Casa Pacifica Centers for Children and Families
92. Catholic Charities Family Counseling and Guidance Center
93. Catholic Family Center
94. Center for Human Development
95. Center for Open Recovery
96. Center for Recovery and Wellness Resources
97. Central City Concern
98. Chautauqua Alcoholism and Substance Abuse Council
99. Chicago Recovering Communities Coalition (CRCC)
100. Child & Family Services, Inc.
101. Child and Family Services of New Hampshire
102. Children’s Friend, Inc.
103. Children’s Home Society of Washington
104. Children’s Law Center
105. Children’s Services of Roxbury
106. CleanSlate Centers
107. Clergy for a New Drug Policy
108. Clinical and Support Options, Inc.
109. Clinical Social Work Association
110. Coalition of Addiction Students and Professionals Pursuing Advocacy (CASPPA)
111. Colorado Society of Addiction Medicine
112. Community Catalyst
113. Communities for Recovery
114. Community Anti-Drug Coalitions of America (CADCA)
115. Community Counseling of Bristol County, Inc.
116. Community-Minded Enterprises
117. Community Oriented Correctional Health Services (COCHS)
118. Community Services Institute
119. Community Solutions
120. Community Substance Abuse Centers
121. Comrades of Hope
122. Connecticut Community for Addiction Recovery (CCAR)
123. Connecticut Society of Addiction Medicine
124. Counselors Obediently Preventing Substance Abuse (COPS)
126. Cutchins Programs for Children and Families
127. DarJune Recovery Support Services & Café
128. Dash for Recovery
129. Davis Direction Foundation - The Zone
130. DC Fights Back
131. DC Recovery Community Alliance
132. Delphi Behavioral Health Group/MHD
133. Desert Eagle Addiction Recovery
134. Detroit Recovery Project, Inc.
135. Dimock Community Health Center
136. Disability Rights Pennsylvania
137. Doctors for America
138. Doctors for Recovery
139. Dorchester Recovery Initiative
140. Drug and Alcohol Service Providers Organization of Pennsylvania (DASPOP)
141. Drug Policy Alliance
142. Drug Prevention Resources
143. East Bay Agency for Children
144. Easy Does It, Inc.
145. Eating Disorders Coalition
146. Edinburg Center, The
147. Eliot Community Human Services
148. El Paso Alliance
149. Engaged Recovery Community Services
150. Faces and Voices of Recovery
151. Facing Addiction
152. Family Advocates of Georgia, Inc
153. Family Focused Treatment Association
154. Family Service Association
155. Family Service of Greater Boston
156. FAVOR Greenville
157. FAVOR Low Country
158. FAVOR Mississippi Recovery Advocacy Project
159. FAVOR Pee Dee
160. FAVOR Tri-County
161. FED UP! Coalition
162. Fellowship Foundation Recovery Community Organization
163. Fenway Health
165. Florida Society of Addiction Medicine
166. Floridians for Recovery
167. Foundation for Recovery
168. Friends of Recovery - New York
169. FSA – Family Service Agency
170. Futures of Palm Beach
171. G III Associates
173. Gandara Center
174. Georgia Council on Substance Abuse
175. Georgia Society of Addiction Medicine
176. Georgians for a Healthy Future
177. Global Alliance for Behavioral Health and Social Justice
178. Gosnold on Cape Cod
179. Gould Farm
180. Granite Pathways
181. Greater Macomb Project Vox
182. Greater Philadelphia Association for Recovery Education
183. Great South Bay Coalition
184. Greater Cincinnati Recovery Resource Collaborative (GCRRC)
185. Griffin Recovery Enterprises
186. Harm Reduction Coalition
187. Health Management Group, LTD
188. High Point Treatment Center
189. Hillview Mental Health Center, Inc.
190. HIV Medicine Association
191. Home for Little Wanderers, The
192. Hope2Gather Foundation
193. HOPE for New Hampshire Recovery
194. Hope House Addiction Services
195. Horizon Health Services
197. Indivisible St. Louis
198. Illinois Association for Behavioral Health
199. Illinois Association of Rehabilitation Facilities (IARF)
200. Indiana Society of Addiction Medicine
201. International Nurses Society on Addictions
202. Institute for Health and Recovery
203. Iowa Association of Community Providers
204. Iowa Behavioral Health Association
205. Italian Home for Children, Inc.
206. Jackson Area Recovery Community
207. Jewish Family and Children’s Services (JF&CS)
208. Joint Coalition on Health
209. Jordan's Hope for Recovery
210. Judge Baker Children’s Center
211. Juneau Recovery Community
212. Justice Resource Institute (JRI)
213. Ka Hale Pomaika'i
214. Kentucky Society of Addiction Medicine
215. KEY Program, Inc., The
216. Kyes 2 a 2nd Chance
217. Lahey Health Behavioral Services
218. Lakeshore Foundation
219. Latah Recovery Center
220. Legal Action Center
221. Lifehouse Recovery Connection
222. Lifeline Connections
223. Long Island Council on Alcoholism and Drug Dependence, Inc.
224. Long Island Recovery Association (LIRA)
225. Lost Dreams Awaken Center, Inc.
226. Lotus Peer Recovery/SoberKerrville
227. Lowell Community Health Center, Inc.
228. Lowell House, Inc.
229. LUK, Inc.
230. Madison County Council on Alcoholism & Substance Abuse
231. Magnolia Addiction Support
232. Maine Alliance for Addiction Recovery
233. Mariah’s Mission Fund of the Mid-Shor Community Foundation
234. Mark Garwood SHARE Foundation
235. Martha’s Vineyard Community Services
236. Maryland-DC Society of Addiction Medicine
237. Maryland House Detox
238. Maryland Recovery Organization Connecting Communities (M-ROCC)
239. Massachusetts Organization for Addiction Recovery (MOAR)
240. Massachusetts Society of Addiction Medicine
241. Maxed Out Drug Prevention
242. McShin Foundation
243. Mental Health Association
244. Message Carriers of Pennsylvania, Inc.
245. Messengers of Recovery Awareness
246. MHA of Greater Lowell
247. Michigan's Children
248. Michigan Recovery Voices
249. Michigan Society of Addiction Medicine
250. Middlesex Human Service Agency, Inc
251. Mid-Michigan Recovery Services, Inc.
252. Midwest Society of Addiction Medicine
253. Mi-HOPE - Michigan Heroin & Opiate Prevention and Education
254. Minnesota Association of Community Mental Health Programs (MACMHP)
255. Minnesota Recovery Connection
256. Minnesota Society of Addiction Medicine
257. Missouri Recovery Network
259. Mountain View Prevention Services, Inc.
260. NAADAC – the Association for Addiction Professionals
261. National Alliance for Medication-Assisted Recovery (NAMA)
262. National Alliance for Recovery Residences
263. National Alliance on Mental Illness
264. National Alliance on Mental Illness – San Mateo County
265. National Alliance to Advance Adolescent Health
266. National Alliance to End Homelessness
267. National Association for Rural Mental Health
268. National Association of Addiction Treatment Providers
269. National Association of Clinical Nurse Specialists
270. National Association of Pediatric Nurse Practitioners
271. National Association of Social Workers (NASW)
272. National Association of State Mental Health Program Directors (NASMHPD)
273. National Association for Children’s Behavioral Health
274. National Association for Rural Mental Health
275. National Association of County Behavioral Health and Developmental Disability Directors
276. National Association of County & City Health Officials
277. National Association of Social Workers (NASW)
278. National Black Justice Coalition
279. National Council for Behavioral Health
280. National Center on Addiction and Substance Abuse
281. National Council on Alcoholism and Drug Dependence
282. National Council on Alcoholism and Drug Dependence of E. San Gabriel & Pomona Valleys
283. National Council on Alcoholism and Drug Dependence--Greater Phoenix
284. National Council on Alcoholism and Drug Dependence – Maryland
285. National Council on Alcoholism and Drug Dependence – San Diego
286. National Council on Alcoholism and Drug Dependence of the San Fernando Valley
287. National Council on Alcoholism and Drug Abuse-St. Louis Area
288. National Disability Rights Network
289. National Federation of Families for Children’s Mental Health
290. National Health Care for the Homeless Council
291. National League for Nursing
292. National Safety Council
293. National Viral Hepatitis Roundtable
294. Navigate Recovery Gwinnett
295. Nevada Society of Addiction Medicine
296. New Futures and New Futures Kids Count
297. New Jersey Association of Mental Health and Addiction Agencies, Inc.
298. New Jersey Society of Addiction Medicine
299. New Life Counseling & Wellness Center, Inc.
300. New Mexico Society of Addiction Medicine
301. New York Association of Psychiatric Rehabilitation Services
302. New York Society of Addiction Medicine
303. New York State Council for Behavioral Health
304. NFI Massachusetts, Inc.
305. NMSAS Recovery Center
306. No Health without Mental Health
307. North Charles, Inc.
308. North Cottage Program, Inc.
309. Northeast Center for Youth and Families, The
310. Northern New England Society of Addiction Medicine
311. Northern Ohio Recovery Association (NORA)
312. Northwest Indian Treatment Center
313. North Suffolk Mental Health Association, Inc.
314. Northern Rivers Family Services
315. North Carolina Society of Addiction Medicine (NCSAM)
316. O’Brien House
317. Ohio Recovery Housing
318. Ohio Society of Addiction Medicine (OHSAM)
319. Oklahoma Citizen Advocates for Recovery & Treatment Association (OCARTA)
320. Old Colony YMCA
321. Open Doorway of Cape Cod
322. Opportunity House, Inc
323. Oregon Recovery High School
324. Oregon Society of Addiction Medicine
325. Overcoming Addiction Radio
326. Parity Implementation Coalition
327. Partnership for Drug-Free Kids
328. Partners in Prevention/National Council on Alcoholism and Drug Dependence of Hudson County, Inc.
329. P.E.E.R Wellness Center, Inc.
330. PEER360 Recovery Alliance
331. Pennsylvania Recovery Organization - Achieving Community Together - (PRO-ACT)
332. Pennsylvania Recovery Organizations Alliance (PRO-A)
333. Pennsylvania Society of Addiction Medicine
334. People Advocating Recovery - PAR
335. Phoenix Houses of New England
336. Phoenix Multisport Boston
337. Pine Street Inn
338. Pivot, Alcohol and Substance Abuse Council of Jefferson County, Inc.
339. PLR Athens
340. Pretrial Justice Institute
341. Prevention Network OCAA
342. Psychiatric Rehabilitation Association
343. Putnam Family & Community Services, Inc.
344. RASE Project
345. REAL- Michigan (Recovery, Education, Advocacy & Leadership)
346. Recover Project/Western MA Training
347. Recovery Allies Of West Michigan
349. Recovery Café Seattle
350. Recovery Community Foundation of Forsyth
351. Recovery Communities of North Carolina
352. Recovery Community of Durham
353. Recovery Consultants of Atlanta
354. Recovery Data Solutions
355. Recovery - Friendly Taos County
356. Recovery Idaho, Inc.
357. Recovery is Happening
358. RecoveryNC (Governors Institute on Substance Abuse)
359. Recovery Point at HER Place
360. Recovery Point of Bluefield
361. Recovery Point of Charleston
362. Recovery Point of Huntington
363. Recovery Point of Parkersburg
364. Recovery Point of West Virginia
365. Recover Wyoming
367. Rhode Island Communities for Addiction Recovery Efforts (RICAREs)
368. Riverside Community Care
369. Robby’s Voice
370. ROCovery Fitness
371. Rockland Council on Alcoholism and Other Drug Dependence, Inc.
372. Sandusky Artisans Recovery Community Center
373. Sandy Hook Promise
374. Serenity Sistas
377. SMART Recovery
378. S.O.A.R™ Yoga (Success Over Addiction and Relapse)
379. Solano Recovery Project
380. Solutions Recovery, Inc.
381. Sonoran Prevention Works
382. South Arkansas Regional Health Center, Inc
383. Sound Community Services, Inc.
384. South Middlesex Opportunity Council, Inc. (SMOC)
385. South Bay Community Services
386. South Carolina Society of Addiction Medicine
387. South Central Human Relations Center
388. South End Community Health Center
389. South Shore Mental Health
390. Southwest Washington Recovery Coalition
391. Spectrum Health Systems, Inc.
392. SpiritWorks Foundation
393. Springfield Recovery Community Center
394. Springs Recovery Connection
396. STEP Industries
397. Steppingstone, Incorporated
398. Steve Rummler Hope Network
399. Student Assistance Services Corp
400. Substance Use and Mental Health Leadership Council of Rhode Island
401. Technical Assistance Collaborative, Inc.
402. Tennessee Society of Addiction Medicine
403. Texas Society of Addiction Medicine
404. The Addict’s Parents United (TAP United)
405. The Alliance
406. The Ammon Foundation
407. The Bridge Foundation
408. The Bridge Way School
409. The Campaign for Trauma-Informed Policy and Practice
410. The Chris Atwood Foundation
411. The Council on Alcohol and Drug Abuse
412. The Council on Alcohol & Drug Abuse for Greater New Orleans
413. The DOOR - DeKalb Open Opportunity for Recovery
414. The Global Alliance for Behavioral Health and Social Justice
415. The Kennedy Forum
416. The Ohana Center
417. The Peggie & Paul Shevlin Family Foundation
418. The Recovery Channel
419. The Rest of Your Life
420. The Trevor Project
421. The Village Family Services
422. The Village Project, Inc.
423. There Is No Hero In Heroin Foundation
424. Tia Hart Recovery Community Program
425. T.O.R.C.H Inc.
426. Toward Independent Living and Learning, TILL, Inc.
427. Transforming Youth Recovery
428. Treatment Communities of America
429. Trilogy Recovery Community
430. True Recovery, LLC
431. Trust for America’s Health
432. Turning Point Center of Central Vermont
433. Two Guys and a Girl
434. UMass Memorial Community Healthlink, Inc.
435. United Methodist Church - General Board of Church and Society
436. Utah Support Advocates for Recovery Awareness (USARA)
437. Valley Hope
438. Veterans Inc.
439. Vermont Council of Developmental and Mental Health Services
440. Vermont Recovery Network
441. Victory Programs, Inc.
443. Virginia Association of Recovery Residences
444. Voice for Adoption
445. Voices of Hope for Cecil County
446. Voices of Recovery San Mateo County
447. Volunteers of America of Massachusetts, Inc.
448. WAI-IAM, Inc. and RISE Recovery Community
449. Walker, Inc.
450. Washtenaw Recovery Advocacy Project (WRAP)
451. Washington Federation of State Employees
452. Washington Recovery Alliance
453. Washington Society of Addiction Medicine
454. Watershed Treatment Programs
455. Wayside Youth & Family Support Network
457. Wellspring Recovery Services
458. West Virginia Society of Addiction Medicine
459. WholeLife Recovery Community/ Arizona Recovery Coalition
460. Wisconsin Recovery Community Organization (WIRCO)
461. Wisconsin Society of Addiction Medicine
462. Wisconsin Voices for Recovery
463. Wyoming County CARES
464. Yoga of Recovery
465. Young Invincibles
466. Young People in Recovery
467. Young People in Recovery – Los Angeles
468. Youth Opportunities Upheld, Inc.
469. Youth Villages
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.