Uncle Sam isn’t giving up on states that have not expanded Medicaid under the ACA. In fact, a recent HHS report argued that expanding Medicaid could do wonders to state efforts to treat opioid abuse, and depression and other mental health issues. Improvements can be budget-neutral or even lead to savings. States that expanded Medicaid did not need to use some of their general funds to pay for behavioral health treatment for the uninsured, the report stated. “While state behavioral health budgets saw state funding cuts during the recession, those that expanded Medicaid were able to find savings to restore former budget cuts, or increase general fund saving,” said the report, issued on March 28 by HHS’s office of the assistant secretary for planning and evaluation.
There are 1.9 million low-income, uninsured people who struggle with a mental illness or substance abuse in the 19 states that have not expanded Medicaid. Those with behavioral health needs make up about 28% of the low-income uninsured individuals in those states.
Low-income adults with serious mental illness are 30% more likely to get treatment if they’re covered by Medicaid. “This will be especially important to states as they work to address opioid disorder and serious mental illness,” the report states. If the remaining states expanded Medicaid, there would be 371,000 fewer people with depression, according to HHS.
In reporting about the HHS effort, the Wall Street Journal pointed out that “opponents of expansion argue that neither states nor the federal government can afford to further swell the program, and that a shortage of providers to treat the newly insured poses an additional challenge in trying to enroll more people in it.”
Those arguments have won the debate in the 19 holdouts, but HHS wants officials to consider the big picture. Quality of life improves for those getting treatment, sure, but also “treating behavioral conditions has been shown to reduce rates of disability, increase employment productivity, and decrease criminal justice costs.”