Statement on Amended Senate Better Care Reconciliation Act

Washington, DC, July 14, 2017 – "The American Association of Child & Adolescent Psychiatry (AACAP) remains steadfast in its belief that all American children and their families need ready access to medical care through insurance coverage, be it private or governmental, including mental health and substance use disorder services," said Dr. Fritz. "Against this requirement, the latest Senate draft of the "Better Care Reconciliation Act" (BCRA) fails that test," he added.

As currently written, the July 13, 2017, BCRA legislative draft would continue making drastic cuts to the Medicaid program over the next decade through reduced government support and an optional block grant approach for states. All this would lead to a significant loss of access to coverage for tens of millions of American families and children, as a new Congressional Budget Office (CBO) score is expected to validate early next week. In 2016, Medicaid/CHIP enrolled nearly 36 million children, and presently Medicaid is the single largest payer for mental health and substance use disorders in the Unites States. "AACAP cannot support cuts of such magnitude, especially when the Children's Health Insurance Program (CHIP) is in urgent need of refunding by October 1, 2017," emphasized Dr. Fritz.

Dr. Fritz further added that, "the amended legislation also would allow for unregulated insurance plans to be sold that do not meet current Affordable Care Act (ACA) standards. Under ACA, the mandatory Essential Health Benefits (EHBs) package must include mental health and substance use disorder services coverage." The new bill language also would dispense with other ACA vital patient protections in such "slimmed down" coverage. These new, largely unregulated plans could be sold in states that are selling at least one ACA-approved plan. Existing ACA patient protections include guarantee renewability, and they ban discrimination based on health status and pre-existing conditions, and prohibit excessive waiting periods. As Dr. Fritz continued, "AACAP is extremely concerned that this new BCRA provision would result in a flood of sub-par products that could give false assurance to beneficiaries and cause existing ACA health plans to cost even more for the sickest children and family members."

"AACAP does not believe that this amended legislation in its current form embodies our mission to promote the healthy development of children, adolescents, and families, nor does the legislation meet the professional needs of child and adolescent psychiatrists," stated Dr. Fritz.

"Nevertheless, AACAP will continue to work with the U.S. Senate in making recommendations on ways to improve our health care system for child psychiatrists and children's mental health needs," he concluded.


The American Association of Child & Adolescent Psychiatry, an affiliated 501(c)6 non-profit organization of AACAP, was formed in 2013 as a way for child and adolescent psychiatrists to increase their advocacy activities.

The mission of the Association is to engage in health policy and advocacy activities to promote mentally healthy children, adolescents, and families and the profession of child and adolescent psychiatry.