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First Lady Chirlane McCray Leads 155-City Coalition to Push President Trump, Congress to Protect Coverage for Mental Illness, Substance Misuse

May 24, 2017

NEW YORK – First Lady Chirlane McCray is leading mayors from across the country to push Congress and President Trump to protect coverage for mental health care and addiction. The 155-city Cities Thrive Coalition is urging President Trump to rethink his budget, which proposes drastic cuts to mental health care, and Congress not to enact the American Health Care Act. The American Health Care Act would eliminate health insurance for 24 million people, cut $880 billion from Medicaid, and increase insurance premiums 15-20 percent. The bill also guts mental health care coverage, leaving the one in five Americans suffering from mental health or substance misuse issues at risk. 

The President’s proposed budget and the American Health Care Act are disastrous to anyone suffering from a mental health condition, struggling with a substance use disorder or addiction. In New York City, over a million people could lose life-saving mental health care coverage under this bill and the President's budget. 

"Currently, people wait an average of up to ten years before seeking treatment for mental illness after symptoms first appear, according to the National Institute of Mental Health. As with any disease, that delay in treatment can hurt chances of recovery. Untreated illness can also prevent people from succeeding at work, at school or make it impossible to build healthy relationships,” said First Lady of NYC Chirlane McCray, who leads the Cities Thrive Coalition and the city's efforts on mental health and substance misuse. "We are in the middle of an opioid crisis and dealing with the fallout of decades of disinvestment in mental health. President Trump and Congress should be making it easier to get care, not hindering progress when we need it most."

“In New York City, the First Lady has taken bold steps to change the conversation and reduce the stigma surrounding mental health. ThriveNYC has connected New Yorkers with mental illness or substance abuse disorder to the care they need,” said Mayor Bill de Blasio. “President Trump's budget will cause pain to those suffering, which is why we must stand together and fight it.”

First Lady Chirlane McCray has also signed on to author a Cities Thrive bipartisan letter addressed to Senate leaders urging them to oppose the American Health Care Act (AHCA).

Addressed to Senate Majority Leader Mitch McConnell and Senate Minority Leader Charles Schumer, the letter, which has 120 signatories, cites how the AHCA would be harmful to those struggling from mental health and substance misuse issues, including:

  • Eliminating Medicaid expansion, which covers 1.2 million Americans with serious mental illness and substance misuse issues;
  • Eliminating the Essential Health Benefits (EHBs) requirement in Medicaid, which means states could eliminate coverage for mental health and substance misuse treatment;
  • Cutting $880 billion in federal funding to Medicaid through the use of a per capita cap or block grant, which would severely limit mental health treatment given that the majority of behavioral health spending comes via Medicaid;

The letter also expresses strong support for the provisions in the ACA which have increased mental health and substance use disorder benefits and provided parity, as well as strong opposition to efforts to convert Medicaid to block grants.   

Follow all the news about the National Mayor's Mental Health Day of Action with #CitiesCare.

Today’s Cities Thrive Coalition’s National Mayor's Mental Health Day of Action involves mayors in cities from coast-to-coast, including Philadelphia, San Francisco, Phoenix, Dallas and more. Mayors are hosting meetings and/or events with federal, state and local leaders, to stress the critical importance of access to mental health care. Under the Affordable Care Act, mental health coverage is an essential benefit for the first time. The Cities Thrive Coalition is calling on Congress to protect this progress.

The Cities Thrive Coalition is a bi-partisan coalition of 155 of the nation’s mayors from all 50 states and D.C advocating in support of a stronger, better funded, and more integrated behavioral health system.

“The cruel Trump budget has deep cuts to programs that help the middle class and working America – like transportation, student loan help, science and health care – while providing more handouts for the rich,” said U.S. Senate Minority Leader Charles E. Schumer. On top of the cuts in the House Trumpcare bill, this budget proposes hundreds of billions of dollars in cuts to Medicaid, which is the course of so much funding for the fight against opioid addiction and the budget proposes millions of dollars in cuts to the Mental Health Services Block Grant. Cutting from these programs will pull the rug out from many Americans in need and hamstring our cities’ and towns’ ability to fight the opioid epidemic head on. Fundamentally, this is a deeply damaging proposal that should be roundly rejected by both parties in Congress.”

U.S. House of Representatives Minority Leader Nancy Pelosi said, "Trumpcare and the Trump Budget both show devastating disregard for the lives of the millions of Americans grappling with mental health conditions or addiction," said House Democratic Leader Pelosi. "The bone-deep cuts of the Trump Budget will make it even harder for these Americans to access the care they need.  Trumpcare guts essential health benefits, which could put mental health services out of reach for many who need them the most.  Communities across America will suffer a great deal of preventable tragedy if Trumpcare or the Trump Budget ever becomes law."

“President Trump told us over and over again, during the campaign and after the election, that he would help improve our health care system,” said U.S. Senator Chris Murphy of the U.S Senate Labor-HHS Appropriations Committee. “He promised that nobody would lose their insurance and that nobody would lose any benefits,” said U.S. Senator Chris Murphy, co-author of last year’s bipartisanMental Health Reform Act. “Instead, Trump and Congressional Republicans are pushing a budget and an ACA-repeal bill that will slash funding for the opioid epidemic, rip mental health care from millions, and literally force those facing addiction out of treatment. I’ll use my positions on the Appropriations Committee and the Health Committee to make sure this budget and theirAmerican Health Care Act never becomes a reality.”

“We know that mental health and substance use disorders can often co-occur, and in the midst of an opioid epidemic that is ravaging states across America, it is critical that we strengthen federal funding to support efforts on the front lines of this crisis,” said U.S. Senator Maggie Hassan of the U.S Senate Health, Education, Labor, and Pensions Committee. I will work to prevent the massive cuts in the Trump budget proposal and Trumpcare – including the proposed decimation of the traditional Medicaid program – that would harm prevention, treatment, and recovery efforts. And I will continue working with my colleagues to ensure that substance use disorder and mental health services continue to be treated as essential health benefits that health insurance companies are required to cover. I am disappointed by the huge gap between President Trump’s words and actions when it comes to this crisis, and we must stand together to prevent these devastating cuts.”  

“President Trump’s budget fails Americans in every way imaginable and his proposed cuts to mental health care in particular, would be devastating for those New Yorkers whose lives depend on access to treatment,” said U.S. Representative Joseph Crowley, Chairman of the House Democratic Caucus. “I’m proud to join First Lady McCray and the Cities Thrive Coalition in urging Republicans in Congress to reject this budget and abandon a disastrous health care bill that further jeopardizes the lives of the people who need care the most.  We need to be focusing on how to strengthen our investments to address mental illness and public health emergencies such as opioid addiction, instead of playing political games with our health care.”

“Too many Americans are grappling with mental illness and substance abuse without adequate support, and Trumpcare and the Trump budget exacerbate this problem. Stealing health care away from millions while reducing essential coverage protections will not help those who are struggling. I applaud First Lady McCray for spearheading this 155-city Cities Thrive Coalition to urge the President and Republicans in Congress to reverse course on these critical issues,” said U.S. Representative Eliot Engel of the U.S House Energy & Commerce Committee.

“President Trump’s budget essentially guts the social safety net, in favor of the military and big money. One of the areas that would be impacted the most is funding that keeps important mental health and addiction treatment programs running, making it harder for the average American family to access the care they need to treat these conditions. Thousands of New York families depend on these programs and can’t afford to lose access to these important services. I joinFirst Lady McCray and the Cities Thrive Coalition in standing in opposition to these cuts and raising awareness around this important issue,” said U.S. Representative Jose Serrano, Ranking Member of the U.S House Commerce, Justice, and Science Appropriations Subcommittee.

“Mental health and substance misuse are two of the greatest health challenges facing our country today. Unfortunately, President Trump’s budget and the American Health Care Act significantly impact our ability to respond to these issues and make it harder for Americans to access treatment,” said U.S. Representative Rosa DeLauro, Ranking Member of the U.S House Labor-HHS Appropriations Committee.“Thank you to First Lady McCray and the Cities Thrive Coalition for bringing attention to these issues and speaking out in support of mental health and substance misuse treatment. We have the opportunity to make a difference in people’s lives, but we cannot do that without funding the programs working in our communities today.”

“One in five of Medicaid’s 70 million beneficiaries who have a mental health or substance use disorder might have no other place to turn if President Trump’s budget and the American Health Care Act are enacted,” said U.S. Representative Grace Napolitano, Chairwoman of the Congressional Mental Health Caucus. “I applaud First Lady McCray and mayors across the country in raising their voices to protect mental health services for all Americans and opposing the President’s dangerous cuts to lifesaving care.”

“For generations, underinvestment throughout our entire mental health care system has left millions of Americans without access to care until it is too late. With deeply misplaced pride, President Trump and a Republican Congress immediately responded to our nation’s ongoing mental health crisis and opioid epidemic by shamelessly celebrating the passage of the single largest attack on behavioral health care in recent history. The Administration’s budget follows in the footsteps of TrumpCare by attacking millions of Americans suffering from mental illness and addiction through draconian cuts to critical community mental health programs. Given this failure in leadership, the voices of mayors across the country are more critical than ever. I applaud First Lady McCray and the Cities Thrive Coalition for their efforts,” said U.S. Representative Joseph Kennedy III of the U.S House Energy and Commerce Committee. 

“President Trump’s budget for FY 2018 adds insult to injury when it comes to mental health and addiction. With the extreme cuts to mental health and substance use disorder treatment in Trumpcare and the even heavier Medicaid cuts the Trump budget, this Administration has shown a dangerous lack of competence regarding the growing mental health and addiction challenges facing our communities,” said U.S. Representative Paul Tonko of the House Energy & Commerce Committee.

“Improving access to mental health and substance misuse services and reducing the stigma associated with care is critical for families in Michigan and across the country,” said U.S. Representative Debbie Dingell of the U.S. House Energy & Commerce Committee.“President Trump’s proposed budget and the healthcare bill passed by the House of Representatives do the exact opposite of what we need to do in this country. These proposals gut essential health benefits and make deep cuts to existing programs, resulting in mental health and addiction services being even further out of reach for families who need them. We need more leadership like First Lady McCray and the Cities Thrive Coalition who are standing up for the mental health and substance misuse treatment our families deserve.”

“Taken together, TrumpCare and the Trump Budget are a direct assault on Americans’ access to affordable healthcare, especially mental healthcare. As we struggle to connect Americans with mental health care and contain the raging opioid epidemic, the Trump Budget will make these crises worse, not better.  You can’t see cancer and you can’t see depression, why should we treat one but ignore the other?” said Representative Robin Kelly (D-IL), Chairwoman, Congressional Black Caucus Health Braintrust.

“The 1 in 5 New Yorkers struggling with a mental illness cannot afford to lose their coverage,” said Council Member Andrew Cohen, Chair of the Committee on Mental Health and Substance Abuse. “We need to be doing everything we can to expand resources for someone struggling with their mental health, not limit them. I hope that our leaders in Congress and the White House will take a serious look at their proposed legislation and think of the people’s lives who may be at risk if they lose this critical care.”  

“This budget will put more people with mental illness out of work, on the streets, and in our jails and emergency rooms. The cost will shift to local communities and law enforcement and put untold hardship on America’s families,” said Mary Giliberti, CEO of the National Alliance for Mental Illness. “We call on Congress to reject this budget and work to improve, not dismantle, our nation’s mental health care.”

“The National Council for Behavioral Health commends the work of First Lady McCray and the Mayors of the Cities Thrive Coalition for organizing and mobilizing to protect key mental health resources. As Washington, D.C continues to promote policies that eliminate key resources for behavioral health it is cities and mayors leading the charge for reform. Through local investment and national advocacy, Mayors across the country are giving a voice to the voiceless by creating a stronger behavioral health system for all Americans,” said Linda Rosenberg, President and CEO of the National Council for Behavioral Health.  

"We applaud First Lady McCray and the 155-city coalition for this initiative," said Paul Gionfriddo, President and CEO of Mental Health America. "The needs of people with mental health needs are considerable, and our nation's mayors see this - and the importance of the ACA to those in need - up close every day."

Chrissie Juliano, Director of Big Cities Health Coalition said, “The proposed cut of more than a billion dollars to the U.S. Centers for Disease Control and Prevention (CDC) would severely hamper urban health departments' efforts to respond to pressing mental health and substance abuse issues, such as the opioid epidemic, which now kills 78 Americans every day. New York City is a member of BCHC, a forum for the leaders of America’s largest metropolitan health departments to exchange strategies and jointly address issues to promote and protect the health and safety of their residents. The Coalition is an independent project of the National Association of County and City Health Officials (NACCHO).”

“This budget is historically harmful for millions of Americans who rely on Medicaid and SAMHSA programs for mental health care,” said Art Terrazas, Director of Government Relations of the American Counseling Association. “ACA joins with the mayors on the front lines of mental health treatment in calling on Congress to enact a budget that responds to the healthcare needs of the American people.  Together we can make our voices heard on behalf of those in need of care.”



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