Thursday, November 4, 2010

What Do This Week’s Election Results Mean For People Affected By Mental Illness

Andrew Sperling, Director of Legislative Advocacy
by Andrew Sperling, Director of Legislative Advocacy

While the political pundits and partisan spinmeisters are still busy on television and on-line analyzing the 2010 election results, a few certainties are starting to emerge regarding how the repercussions this may play out in 2011 and beyond for people living with mental illness and their families. While the impact is far from certain, we can predict with some precision what the shift of partisan control in Congress will mean–both in terms of the Republicans taking over the House and the Democratic majority in the Senate being significantly reduced.

A few things we anticipate include:

Discretionary Spending Will Remain Flat in 2011 and 2012

At minimum, the Obama Administration is expected to come forward with a flat budget proposal for fiscal year 2012 in February–with exceptions made for defense and veterans. The new House Republican majority is likely to go even further and seek to cut domestic discretionary programs back to fiscal year 2008 levels. This could mean as much as a 7 percent reduction for mental illness research at the National Institute of Mental Health–from $1.541 billion, down to $1.405 billion–ASSUMING the President relents and accepts cuts of this level to domestic spending.

The Increase in Federal Medicaid Payments (FMAP) Will Not Be Extended

In light of revenue shortfalls in almost all of the states, the federal government provided a temporary increase in the Federal share of Medicaid spending. which was scheduled to end on December 31, 2010 and extended until June 30, 2011, albeit at a reduced rate. The combination of concern over federal spending  with the changes in Congress would suggest that chances of extending this federal support to states is unlikely to be extended again. Not a single House Republican voted for the higher FMAP last summer, so there is little expectation that the new majority would be supportive of extending higher FMAP any further in 2011.

It will be Difficult to Repeal Healthcare Reform

The political realities of repealing a law make this scenario very unlikely, principally because of President Obama's veto power. Another complication is that some parts of health care reform already in effect are pretty popular. Among them are provisions forcing insurers to cover children with pre-existing conditions and allowing parents to keep kids up to age 26 on their policies. That's why you hear so many pundits asserting that any potential rollbacks would be more piecemeal rather than a full-scale discard.

While we will likely see many proposals related to changing the healthcare reform law, most concerning for NAMI and people with mental illness will be efforts to scale back or delay the Medicaid expansion scheduled for 2014. As noted above, federal discretionary funding will not be growing and additional federal Medicaid assistance is unlikely. The consequences of these actions will put further pressure on state and county budgets, further eroding resources for publicly funded mental health services which are critical for many people who live with mental illness.

A more thorough analysis of what the election results might mean for people with mental illness will be published in the November edition of the NAMI e-Advocate. To subscribe, sign up for this monthly e-newsletter.


Anonymous said...

take away from mental health, take away from disabled, take away from the ones who really need it, but don't dare take away from their pockets

Anonymous said...

Just where do you think the money for any increases would come from? There is only so much money. An increase in payouts means an increase in your taxes. Look at France where they are rioting because the government can not afford to take care of them anymore.

Theresa said...

What can we as mental health advocates do? Many of us depend on the public system or at least parts of it.

I don't want to just be sad and roll over- I hope in the Nov Advocate- ideas and call to action plans are given. Thanks TM

Anonymous said...

I don't think Obama will allow too much bad stuff to happen... but bad stuff always has a way of making an appearance, even when you think the coast is clear.

Anonymous said...

sometimes I think "why don't we all go on Medicare and call it a day!" (easier said than done I'm sure)

Anonymous said...

A valuable lesson instilled in me so long ago was to not complain without a solution or suggestion.

Where is the suggestions for NAMI and NAMI members of what can be done in these difficult times to support our cause? It is a report of doom and gloom.

Another National spokesperson has addressed a situation in this same manner with me when I looked to him for support and leadership.

It is concerning to me that the
National team is responding in this defeatist manner. I need positive suggestions,leadership amd role models. It is important to me that the team not give up before it even formulates a strategy.

Please seriously consider this post. I have tried to contact NAMI National staff members to
receive no return response email.
Should I have called instead?

I understand that there must be a tremendous overload of schedules, but unresponsivenes to members is a sure way to lose members. Is this acceptable?

There is another post on this
blog asking what advocates can do.
Members are looking for direction and suggestions. Not just a negative report of the future. An action plan.

We need leaders to be realistic, but it seems there has been a resignation to the cause. I do not think anyone wants blind optimism.

Does the National leadership have interns in the office who can provide some fresh perspective, ideas and positive energy?

This is constructive criticism because I and others like me need
NAMI's strength. It is possible for NAMI to be so much more than
the positive model it is now.

Please advise all National Staff to read this post. It would be helpful to meet and form a positive plan.

Or just even reread this blog and
consider what could have been
added to help the members do something constructive about the

Thank you for your consideration.

Anonymous said...

Since this blog discusses politics and how it will affect mental illness, I would like to discuss the Health care reform law.
In particular, the provision for the 30 Centers of Excellence for Bipolar and Depression that became law.

As you are aware, the funding was not approved with the law, so it has to be appropriated by Congress for the next 5 years. This past July 10 million dollars out of a possible 100 million dollars was appropriated for the project.

NAMI was under the impression no funds would be appropriated which I thought was taking a defeated
position before the decision was even made.

As a NAMI dues paying member & family members are also, I am curious about NAMI's strategy to obtain the maximum 100 million dollar funding for these Centers of Excellence for the next 5 years during July.

Research for Mental Illness is of the upmost importance. Without research, the movement is stagnant with no progress. This funding is vital to the mental health community. If there is no improvement in quality of life due to lack of research and better treatments than do people think those with mental illness really care about jail diversion, housing
or medication benefits?

People without the illnesses do not realize the most important thing to those of us that suffer with mental illness is to feel better. That will only come with research and better treatments whether that includes medications, alternative therapies and/or medical devices.

I am disappointed that there seems to be a lack of response to these blogs compared to when they began.

The recession is not preventing research for mental illness. Becaue the health care bill is full of provisions that are much more expensive than these Centers.
It is just that politicians chose to not fund a project for mental health.

Why do Aides patients have better health care treatment and reserch
than patients unfortunate enought
to have the illness of a brain disorder? This has to stop.

The statistics support the case for mental health funding, so there is some other reason that it is stalled. The incidence of mental health problems and the cost to society alone should be enough to receive funding.

Please provide a new strategy for members to get behind this legislation in addition to other
organizations. Once funding for these Centers is obtained it may open the gates for perhaps Centers for Schizophrenia and other disorders.

There are obscure and rare diseases that have Centers of Excellence, specialized Centers for treatment and research. If they are able to obtain these Centers with little support, why
are there not Centers for Mental illness?

I hope to recieve some response with an action plan to further this project along which already has momentum. It would be
foolish not to build on that momentum.

Thank you.

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