As a psychology major at Marshall University in West Virginia, my career path will be directly affected by the repeal of the Affordable Care Act.

There is a current mental health initiative focused on providing mental health services to rural communities. Fellow students from within the state tend to be vocal in the classroom about particular systematic disadvantages of Appalachia. The summer 2016 flood and the water poisoning of 2014 are readily recalled as large environmental factors. Historically, Appalachians have fallen behind in education and infrastructure while leading in things like obesity, unhappiness and cost of living expenses despite a rural identity. The current hot topic for West Virginians and particularly Huntingtonians, is the drug epidemic. Citizens, politicians and mental health professionals seem desperate to find a quick resolution to the growing problem. Substance abuse and addiction treatment is an area within the field of psychology.

The states most affected by the opioid epidemic voted Republican in the 2016 election, including West Virginia. In fact, West Virginia is projected to be the second-most affected state by an ACA repeal due to uninsured individuals, a crippling economy under a lack of federal funding and the loss of up to 16,000 jobs. Republicans have consistently offered an ambiguous plan for a repeal and replacement of the ACA. This proposed replacement has not manifested any substance of policy as of yet. The general public still remains curious of what the replacement will cover/offer. Nationally, up to 4 million Americans could lose access to mental healthcare. Sen. Shelley Moore Capito, R-W.V., has proposed that the replacement would include provisions for mental health and substance abuse, but she has a much higher incentive to say that now than other congressional Republicans. West Virginia’s number of uninsured individuals is the lowest it has ever been, having gone from 14 percent in 2013 to 6 percent in 2016.

Aside from politics, I encourage you to think about the societal implications. What would this mean for those that, without mental health treatment, end up in jail? They would continue to eat up precious tax dollars and further the mass incarceration rates in our country. Not to mention, the ethical side of the matter in which the repeal would directly ruin the life trajectory of many otherwise functioning members of society. What would this mean for those seeking treatment for addiction, more specifically in our region? It is easy to dehumanize those with addiction. Some are angry at the resources used towards their treatment. There would be extreme implications if the field of substance abuse treatment does not continue to make systemic change within our region. Huntington and all of its residents will suffer from a restriction of substance abuse treatment. Many substance abusers that are mid-treatment and goal-oriented could potentially have their inhibitory medications and counseling taken from them, placing them back at square one facing their addiction by themselves.

According to The New York Times:

“In Kentucky about 11,000 people were receiving addiction treatment through Medicaid by mid-2016, up sharply from 1,500 people in early 2014, according to the Foundation for a Healthy Kentucky, a health policy research group. In West Virginia, Ms. Rosenberg of the National Council for Behavioral Health said, her group’s member organizations — nonprofit providers of mental health and addiction treatment — are now treating 30,000 people a year, up from 9,000 before the health law.”

Politicians and medical professionals need to hold pharmaceutical companies accountable. Unfortunately, it also appears we the people are going to have to hold politicians accountable for doing their job and protecting the disadvantaged regions of West Virginia from pharmaceutical companies and the removal of their access to healthcare. Politicians have actively ignored questions about mental health coverage. For example, Rep. Kevin Brady, a House Republican dedicated to streamlining healthcare, answered a question about future mental health coverage in an ACA replacement with, “we’re focused on reforms that will encourage innovation and competition — so there are more health care options to meet the unique needs of different individuals and families.”

Many are able to explain this away as a partisan issue. I am unable to see it this way. Ethically, the removal of access to healthcare for 20-some million people is horrific in itself. But as a future psychologist, I have to ask what this will mean for my career. Marshall has come very far to be recognized and revolutionize the way mental health is viewed and accessed within our state. The ACA is the vehicle that will allow our field’s work to be treated and respected like a traditionally “medical” profession. Our graduate program has a strong focus on rural access to mental healthcare. There are Democrat psychologists and there are Republican psychologists. The underestimation of the effects of an ACA repeal on West Virginia residents and the field of psychology as a whole would be criminal regardless of party affiliation.

Bradley McCoy can be contacted at [email protected].