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Tom Watkins
Tom Watkins

Don’t Gut the ACA

March 24, 2017 

As Congress and the Trump Administration deliberate over how best to “repeal and replace” the Affordable Care Act (ACA), let us consider how this will impact us nationally, here in Michigan, and more specifically in the tri-county region of Oakland, Macomb and Wayne counties.

Nearly 300,000 Healthy Michigan/ACA enrollees (182,000 in Wayne + 55,000 in Oakland + 44,000 in Macomb) in the metro region will lose access to health care by the year 2020 under the Republican plan.

The repeal and replacement of the ACA, as currently proposed, will strip needed health benefits from vulnerable people – our family members, friends, and neighbors. 

With the repeal of the ACA, 660,000 people in Michigan are at risk of losing their needed health care insurance benefits. In general, poor children, the elderly, and persons with disabilities will be disproportionately affected by any changes in ACA. Nationally, Medicaid insures 30 million children. In Michigan, 54.9 percent of individuals on Medicaid are children.

The nonpartisan Congressional Budget Office, led by Republican appointed Keith Hall, came out with estimates that the American Health Care Act will result in 26 million less people being insured nationally by 2026. Be clear, these people will still be in need – they don’t simply disappear.

This plan shifts the cost of insuring the poor from the federal government to the states, but will not increase the number of individuals with health insurance. Many states are likely to see this option as unaffordable and will eliminate coverage for this vulnerable population who live just over the federal poverty line.

In the metro region alone, the State of Michigan would need to allocate an additional $112 million ($70m DWMHA + $19m Macomb + $23m Oakland) to ensure there is no disruption in critical services for more than 31,000 persons with severe and persistent mental illness, intellectual and/or developmental disabilities, and/or substance use disorders. All of these individuals are currently receiving services funded by Healthy Michigan.

The “Repeal and Replace” plan will remove the requirements that Medicaid include vital mental health and substance use services, and that these services receive the same parity as provided for physical health care. This threat comes in the midst of what is being called the worst drug crisis of all time. Tragically, in 2015 more than 33,000 Americans lost their lives to the opioid epidemic.

It is estimated that approximately 60 percent of the population in county jails and state prisons have a mental illness. Reduced mental health and substance use care will only increase the numbers in our criminal justice system.  This is a terrible injustice to them and a tremendous expense to taxpayers.

The Healthy Michigan Plan (HMP) has reduced the number of people who were utilizing the emergency room for their physical and mental health care. Many of these individuals are now receiving timely preventive, and appropriate care in their physicians’ office, according to Chris Priest, Medicaid Director for the Michigan Department of Health and Human Services. If people covered by HMP lose this valuable insurance benefit, preventive will again be replaced with emergency room visits or left untreated.

We urge Congress to listen to governors, like our Governor Snyder, to retain healthcare for our most vulnerable citizens, persons with serious mental illness, children with emotional disturbances, individuals with intellectual and developmental disabilities and persons with substance use disorders.

We ask Congress to:

  • Commit to maintaining the mandate that mental health and substance use and prevention services are included in all health plan as an essential benefit.
  • Ensure ongoing support and the financing of Medicaid expansion with a Federal match rate that is sustainable for the states.
  • Safeguard insurance benefits for individuals with disabilities, and identify them as the priority group for any changes in the health care legislation.
  • Cultivate a society that is defined by how it treats the poor and vulnerable. Stripping the poor and persons with disabilities of healthcare is unhealthy for our state and nation.

We encourage all concerned citizens to call their Congressional representatives and ask for sensible reforms to the ACA, and to resist the gutting of a law that is making Michiganders and Americans healthy.

– Tom Watkins, President and CEO, Detroit Wayne Mental Health Authority 

– Willie Brooks, Executive Director and CEO, Oakland County Community Mental Health Authority 

– John Kinch, Executive Director, Macomb County Community Mental Health 

Tom Watkins  served the citizens of Michigan as state superintendent of schools and state mental health director. He is the President and CEO of the Detroit Wayne Mental Health Authority ( He can be emailed at:, or followed on twitter at:@tdwatkins88


March 23, 2017 · Filed under Tom Watkins



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