ALEXANDRIA, Va., — A new study shows that nearly four million people with mental illnesses who are uninsured reside in the 25 states, including Mississippi, that have refused to participate in the Medicaid Expansion program under the Affordable Care Act (ACA).
According to the findings of the American Mental Health Counselors Association (AMHCA), many of these individuals have severe mental health conditions and currently have no health insurance coverage through any public or private plan, but will be denied the opportunity to obtain coverage for treatment since those states have refused to participate.
States declining Medicaid Expansion represent 55 percent of all uninsured people with major mental health disorders who are eligible for coverage in the new health insurance access initiative.
The study — “Dashed Hopes, Broken Promises, More Despair: How the Lack of State Participation in the Medicaid Expansion Will Punish Americans With Mental Illness,” released by the AMHCA — shows that 6.7 million uninsured people with a mental illness are currently eligible for coverage under the Medicaid Expansion that went into effect on Jan. 1, 2014. But the majority of these individuals with mental health conditions will be left out in the coverage cold due to their state’s antagonism toward the Medicaid Expansion health insurance initiative.
Key findings from the AMHCA report include:
• Nearly four million uninsured people (3.7 million) who have a serious mental illness, are in serious psychological distress or who have a substance use disorder are eligible for health insurance coverage through the new Medicaid Expansion program in the 25 states that have rejected participation in the initiative.
• Nearly 75 percent (2.7 million adults) of all uninsured persons with a mental health condition or substance use disorder who are eligible for coverage in the non-expansion states (3.7 million), reside in these 11 Southern states that have rejected the Medicaid Expansion: Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas and Virginia.
• More than 1.1 million uninsured people who have serious mental health and substance abuse conditions live in just two states — Texas (625,000) and Florida (535,000). These more than 1.1 million individuals are eligible for coverage under the new Medicaid Expansion program, but won’t receive it. Since officials in Texas and Florida (and other 23 states) have said they will not participate in the initiative, they are leaving their most vulnerable citizens without health insurance, even though the federal government will pay for it (at 100 percent for the first three years of the program and slowly tapering off to 90 percent in 2020 and thereafter). The funds for this are already included in the federal budget.
“If the 25 states do not participate in the new Medicaid Expansion program, uninsured citizens with mental illness who experience the misfortune of residing in those states will see their hopes of a healthier and better life dashed when they learn during the enrollment process that they will not be able to obtain health insurance,” said Judith Bertenthal-Smith, president of AMHCA.
According to the AMHCA, states expanding Medicaid will have enhanced capacity to meet the needs of millions of previously uninsured people with mental illness, which will intensify the treatment disparity gap between states. The 25 non-expansion states will be further left behind as those states that do expand Medicaid will see an influx of new federal monies to shore up their mental health systems, which have witnessed ruinous cuts since 2000.
The U.S. Supreme Court ruled in 2012 that the new Medicaid Expansion program — which started on Jan. 1, 2014 — is an optional program; states can opt into or out of it at any time without incurring penalties. But states that perpetually opt out of Medicaid Expansion will hurt people with mental illness, AMHCA claims.
“The burden of mental illness in the U.S. is incredibly high due to increasing numbers of uninsured people with mental health conditions. The lack of health insurance coverage keeps people with mental illness from obtaining needed services and treatments — and follow-up care — that lead to achieving long-term recovery and improving their quality of life,” said Joel E. Miller, executive director and CEO of AMHCA and author of the “Dashed Hopes” report. “Health insurance is the passkey to good, timely health care services, and state policymakers in 25 states are locking people out of the system.”