The last time I wrote about how Republicans and Democrats are both failing mentally ill people, there was some objection to my point. Namely, that I was being unfair to Congressional Republicans by saying that they don’t care about mentally ill people.
This week, Congressional Republicans are making my point for me again. Sure, they generally oppose LGBT rights, protections for low-income people and criminal justice reform, issues which directly affect the mentally ill, since a significant portion of LGBT people, low-income people and people who interact with the criminal justice system have some form of mental illness.
But why take these correlative points as proof when you can have your senators and representatives tell you straight out?
The newest — and probably final — attempt to repeal Obamacare via budget reconciliation rather than regular order tells me all I need to know about what the people who wrote it (and the people who’ll vote for it) think about mentally ill people.
First, it allows insurers not to cover mental illness at all. People who need mental healthcare are already not always likely to get it: Nearly 60 percent of mentally ill people haven't received any in the last year. Of that 60 percent, 47 percent say that the cost of the care is the reason they don’t seek it — and there is no reason for any intelligent person to believe that allowing public insurers not to cover the cost of care would drop that percentage.
And after seven years of the ACA offering that coverage, it is even more unthinkable to retract it. Care for people with mental illness is expensive — for one family, anorexia treatment can cost $11,000 a year, and it will not be a one-year illness. That cost will be repetitive. Presently, an insured person with bipolar disorder might pay $5,000 for his or her first year of treatment. If that person becomes uninsured, the costs average around $19,000.
Even under Obamacare, costs are high. Despite the fact that mental healthcare was supposed to be covered under the law, insurers frequently found loopholes that allowed them to cover less of the cost. In 2016, President Obama formed a task force that was supposed to save mentally ill people from this cost disparity, which probably did some good, but proves the point that mentally ill people were never well-protected from high healthcare costs.
Still, while it could have been better, Obamacare did improve access. Taking that access away now is unacceptable — people who have relied on the care that it allowed them to afford for seven years will be left high and dry, without the medications or therapy that have helped them to cope with their illnesses.
And all those people who were diagnosed and received care under the ACA? Well, if this bill passes, they might have been better off just suffering for seven years, because now that diagnosis might be a pre-existing condition, which would also be exposed to insurer choice under this new Republican plan. Thanks to the fact that some mentally ill people had the nerve to get help when they needed it, they may now find themselves uninsurable.
Additionally, the Cassidy-Graham-Heller-Johnson bill (referred to with all four names so as to appropriately assign blame for its writing) does not require insurance to cover substance use disorders, which both fall under the umbrella of “mental illness” and often presents alongside other mental illnesses as a maladaptive coping mechanism. There is, again, no reason to expect that public insurers would continue to provide ACA-required coverage for people with substance use disorders out of the goodness of their hearts.
This last part particularly underlines the hypocrisy of the whole thing: Prominent Republicans discuss the opioid epidemic all the time — and electorally as well as morally, they should, since it’s particularly ravaging rural areas, which largely vote red. But when it comes time to actually do something about the problem and provide people hooked on opioids with the help that they need, they’re nowhere in sight. In fact, they’re running in the opposite direction entirely.
Let this bill make one thing very clear: Republicans in power do not care about the mentally ill. They like to pretend they do when somebody throws them a softball on opioid use or when it comes time to shift blame for violence from guns to “crazies,” an argument they frequently make in tandem with Democrats.
But don’t believe the people who wrote this bill when they talk that big game about how we could solve violence if we could just get mentally ill people help. And don’t believe the people who vote for it — see: many, if not most Senate Republicans — when they say they care about the people dying of heroin overdoses in their states. People who care about problems do not, when given the power to fix them, instead opt to make them worse.
They don’t care. Don’t forget that when it comes time to reelect them.