President-elect Donald Trump said on his website that he will start working to repeal the Affordable Care Act as soon as he takes office. However, Trump told nonpartisan organization Science Debate that the national government should provide support to state and local mental healthcare efforts.
Trump has not announced a specific policy for mental healthcare, but on his website, his general healthcare policy says, “Families, without the ability to get the information needed to help those who are ailing, are too often not given the tools to help their loved ones.”
Carolyn Engelhard, associate professor of public health sciences and public policy, said it is unlikely that the Affordable Care Act will be repealed, but that Trump may be able to work with a Republican Senate to weaken it.
“Even without 60 votes, on the Senate side they can pass a budget reconciliation bill which eliminates a lot of the funding for the ACA, which would in effect disable many parts of it,” Engelhard said. “But the Republicans right now really don’t have a good substitute plan to replace it without unleashing a lot of uninsured people, making people uninsured, which will be very unpopular politically, with the American voter who may be benefiting from the ACA.”
Engelhard also said weakening or repealing the ACA could result in a return to practices like charging different insurance rates for the young and the old, and higher rates for women than for men.
Paying for mental healthcare can be a murky issue, because mental health issues tend to fall on a continuum, ranging from people with severe disabilities to those sometimes known as the “worried well” — those who do not have diagnosable illness, but would like to improve their mental health. Trump has not said what he intends to do for those with mild to moderate illness.
Trump also said that mental healthcare reforms must be part of larger, more general healthcare reforms. University Democrats President Sam Tobin, a fourth-year College student, said that while he would like to see mental healthcare included in general healthcare, it’s most important that mental healthcare spending be increased.
“I believe the statistic is one in four Americans have mental health concerns, and we need to as a society to start addressing that better, and I think Hillary does have detailed policies to do [that], and Trump — as per every single other issue — doesn’t have anything,” Tobin said.
Trump has also said that he would like to increase the number of mental healthcare providers at the U.S. Department of Veteran Affairs, while at the same time, encouraging to seek mental healthcare outside of the VA, though he did not make it clear how that would be paid for.
The College Republicans did not respond to requests for comment.