We talk a lot about Medicaid Expansion on this blog because we know it is vital to improving access to health care for millions of people. But sometimes it’s helpful to review how it will help people. According to a new study, one such way is by improving access for mental health.
Last week the National Alliance on Mental Illness (NAMI) released a report illustrating one of the many things states have to gain by taking the federal funds to expand Medicaid. Nationwide, more than 2.7 million uninsured people with mental illness can get covered if all states accept the federal funds. While the nation-wide impact provides important context, the report also includes a chart with the state-by-state numbers of people with mental illness who would be helped (see page 9 of the report).
In Florida, 244,000 people are not getting the mental health care they need. Even though the federal government is willing to pay for 100 percent of their care, these people will not be helped because their state legislature will not support expanding Medicaid. In Michigan, currently a “maybe” expansion state, 105,000 people need access to mental health care. California, a state accepting the expansion, and Texas, a state that has not yet accepted, each have more than 255,000 residents who would benefit!
The chart also lists the percentages of uninsured people with mental illness who would be eligible for Medicaid. Some of the states are staggering. More than 30 percent of people without insurance who would be eligible for Medicaid in Minnesota and Nebraska have mental illness. Yet sadly only one of those states, Minnesota, will expand in 2014.
Mental illness has risen to such importance that it was the focus of today’s White House conference. The President reminded us that the brain is a part of the body and deserves treatment just like our broken hearts and bad hips. Advocates were heartened to hear that Secretary Sebelius reaffirmed the Administration’s commitment to finish mental health parity regulations this year, as they stated in January. With fewer than half of Americans with mental illness receiving treatment, Medicaid expansion can help improve the situation dramatically. The tragic shooting in Newtown, Connecticut and other awful events are reminders about the importance of treating this often hidden disease.
The NAMI report highlights the concerning status of mental health in our country—and yet the substance use disorders treatment situation is even more dire. Only 1 in 10 people with addiction receives the treatment they need, making addiction the most undertreated illness in our nation. Thankfully the Affordable Care Act includes benefits for this chronic disease and expands parity to help ensure this coverage is meaningful. (There is more work necessary at the state level to ensure these benefits are implemented so they most benefit consumers. For more, see our substance use disorders page.) The new health insurance marketplaces will help higher income uninsured people get covered, and those who live in expansion states will have Medicaid as an option.
Mental health and substance use disorders affect millions of uninsured Americans, but whether many will get help in 2014 is undetermined. The solution to each problem is the same: expand Medicaid. Take the federal money to help people get access to much needed care. Sixteen states are still “on the bubble” – advocates need to take the behavioral health message to their leaders so that people with brain diseases can get the help they so desperately need.
– Tom Emswiler, Policy Analyst