Alliance Alert: TOMORROW IS ELECTION DAY! We scanned the internet to find the best comparison of the mental health policy proposals advanced by former President Donald Trump and Vice President Kamala Harris. See excerpted mental health and addiction related proposals from a much broader analysis put forward by KFF (formerly the Kaiser Family Foundation).
If you haven’t voted already, make sure you get to the polls!
As the legendary disability rights leader Justin Dart said “VOTE as if your life depends on
it—Because it DOES!”
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Compare the Candidates on Health Care Policy
Excerpts by the Alliance for Rights and Recovery
KFF (formerly The Kaiser Family Foundation) October 8, 2024
MENTAL HEALTH
Donald Trump
- Proposes a return to mental institutionalization, stating, “for those who are severely mentally ill and deeply disturbed, we will bring them back to mental institutions, where they belong” — moving away from longstanding policies that provide treatment and living in community settings.
- Supported repeal of the ACA and cuts to Medicaid, which would reduce coverage and access to behavioral health services, and issued an executive order to expand non-ACA-compliant short-term policies that often limit or exclude mental health services.
- Signed pandemic legislation (CARES Act) that included an expansion of Certified Community Behavioral Health Clinics (CCBHCs), signed legislation that established the 988 hotline, and issued an executive order on veteran suicide.
Kamala Harris
- As vice president led the White House’s Blueprint for Addressing the Maternal Health Crisis, which has taken steps to address maternal mental health, such as launching the National Maternal Mental Health Hotline, training providers on maternal mental health and substance use disorders, and calling on states to expand and extend Medicaid postpartum medical and mental health coverage.
- The Biden-Harris administration made investments to expand mental health and substance use treatment, including to children and families and underserved populations, and to address the mental health workforce shortage by increasing licensing flexibilities for social workers.
- The administration supported and enacted the Safer Communities Act, which included provisions to increase school behavioral health services (building on the administration’s American Rescue Plan Act) and strengthen state requirements for behavioral health care for Medicaid-enrolled youth, in response to worsening youth mental health.
- The administration enhanced behavioral health access opportunities for Medicaid enrollees by establishing maximum appointment wait times, surveying enrollee experiences, and adding rate transparency policies, which may result in improved rates and more provider participation.
- The administration expanded the Medicaid CCBHC Demonstration by adding 10 new states to the program.
- The administration enhanced crisis care by building up 988 and mobile crisis services, and released the National Strategy for Suicide Prevention, with focus on high-risk groups (e.g. LGBTQ+, veterans, moms).
OPIOID USE DISORDERS
Donald Trump
- Declared the opioid crisis a public health emergency, signed bipartisan legislation (SUPPORT Act)
- 2024 campaign proposes a heavier-handed law and order response to opioids, including reviving restrictive border policies, increasing federal law enforcement involvement in local drug investigations, and seeking the death penalty for drug smugglers and drug dealers.
- Plans to support faith-based substance use treatment and job placement but emphasizes a forceful approach for homeless people with mental health and substance use needs, stating ending “the nightmare of the homeless, drug addicts, and dangerously deranged” by arresting or relocating individuals to “tent cities” staffed with health workers on large parcels of inexpensive land.
Kamala Harris
- The Biden-Harris administration established a multi-pronged response to the opioid epidemic, including reducing the supply of illicit substances like fentanyl, launching educational and awareness campaigns like “One Pill Can Kill” to raise awareness about fentanyl and emerging threats like xylazine, and improving prevention and access to evidence-based treatment.
- The administration reduced barriers to medications for opioid use disorder by updating regulations for methadone dispensing programs to improve access, extending temporary rules that allow buprenorphine administration via telehealth, adding substance use treatment training requirements for providers, removing provider registration requirements prescribing treatment medication, and permanently requiring state Medicaid plans to cover medication-assisted treatment (through the 2024 Consolidated Appropriations Act). The administration extended funding for state and tribal opioid response grants to support states in distributing opioid overdose medication and continuing initiatives that increase access to opioid treatment services and medication.
- The administration expanded access to medication treatment in correctional settings by allowing states with approval to use Medicaid funds for addiction treatment services up to 90 days before release and by updating regulations that improve access to methadone treatment in jails and prisons.
- Following the FDA’s approval of over-the-counter opioid overdose reversal medication under the administration, the White House established the Challenge to Save Lives from Overdose, which is a nationwide initiative to increase training on overdose reversal and improve availability of overdose reversal medication in public and private organizations across all sectors.
MEDICARE
Donald Trump
- Promises to “always protect Medicare, Social Security, and patients with pre-existing conditions” including no changes to the retirement age (no specific policies proposed).
- Proposes to eliminate taxes on Social Security benefits, which would accelerate insolvency of the Medicare Hospital Insurance and Social Security Trust Funds.
- Signed legislation that expanded treatment for substance use disorders and other mental health conditions and allowed Medicare Advantage plans to offer additional benefits for chronically ill enrollees.
Kamala Harris
- Biden-Harris administration proposes to “protect Medicare for future generations” in part by extending solvency of the Medicare Part A Trust Fund by raising Medicare taxes on high earners and closing tax loopholes, and proposes to expand Medicare and Social Security (details not specified).
- Proposes expanding home care services under Medicare to help people with functional or cognitive impairments (see also Long-term Care), and adds a vision and hearing benefit to Medicare, paid for by expanding Medicare drug negotiations and other policies.
- As vice president, cast the tiebreaking vote in the U.S. Senate for the Inflation Reduction Act, which included several provisions to lower Medicare prescription drug expenses, including negotiated drug prices and a $35 monthly insulin cap (see also Prescription Drug Prices).
- The administration expanded coverage of mental health services and access to additional mental health providers.
GUN VIOLENCE
Donald Trump
- Reversed Obama-era regulations that required those eligible for Social Security Administration mental disability payments to be blocked from buying guns and made it easier for gun-safety devices to be more widely accessible.
- Has frequently attributed community gun violence and violent crime to both mental illness and immigration, stating that “they’re not humans, they’re animals.”
Kamala Harris
- The Biden-Harris administration supported and signed the Bipartisan Safer Communities Act into law, which enhanced background checks for individuals under 21, funds crisis intervention orders, and invests in mental health services, including school-based mental health services.
https://www.kff.org/compare-2024-candidates-health-care-policy/