How Repealing and Replacing the ACA Could Reduce Access to Mental Health and Substance Use Disorder Treatment and Parity Protections

A woman smokes a cigarette outside a building, at dawn.

Analysis finds the American Health Care Act (AHCA) could limit access to mental health treatment.




The Issue

Mental health and substance use coverage could roll back to pre-Affordable Care Act (ACA) levels if the AHCA becomes law.

Key Findings

  • Prior to 2008, nearly two-thirds of people with employer-sponsored insurance had special limits on inpatient behavioral health coverage, and three-quarters had limits on outpatient behavioral health coverage.

  • The ACA provides coverage and parity protections for mental health and substance use disorder treatment to millions of Americans, many of whom were previously uninsured.


The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 required mental health and substance use disorder benefits parity in large, employer-sponsored plans. The ACA extended those parity protections to certain Medicaid plans and individual and small group health plans.

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