Medicaid: A vital lifeline for mental health care

Friday, February 17, 2017 5:16:09 PM

By Mary Gilberti, JD, Opinion Contributor, The Hill

Originally posted February 14, 2017  


In December 2016, Congress enacted landmark legislation to improve care for Americans with mental illness. These provisions reflected strong, bipartisan consensus that fixing the broken American mental health system must be a national priority and something we cannot ignore.

Today, barely two months later, Congress is considering changes to Medicaid that could significantly set back the cause of improving mental health care and deny care to millions of Americans with mental illness.

Medicaid is the most important funder of services for people with mental illness in the U.S. About one-third of people added to Medicaid in the states that have expanded this program live with a mental illness or substance use condition. Many of these individuals live with the most serious mental health conditions, and are vulnerable to hospitalizations, homelessness or involvement in the criminal justice system.

Medicaid provides people with access to services that private insurance policies typically do not cover. They include Assertive Community Treatment (ACT), an evidence-based practice with a long track record of success, in which mental health workers reach out to help persons where they live, rather than wait for them to come to see them.

Medicaid is also important as a catalyst for early identification and intervention in the treatment of emerging mental illness. These services enable young people to remain in school and work. It keeps them on the trajectory of life-long success, preventing long-term dependence on public support.  

Governors throughout the country know how important Medicaid is for people with mental illness. Ohio Republican Gov. John Kasich recently wrote to key members of Congress, describing how Ohioans with mental illness and addictions have benefited from his state’s decision to expand Medicaid. These benefits included significant improvements in overall health status, reductions in use of emergency rooms, higher rates of employment and reductions in the numbers of people uninsured. Kasich urged Congress to give states “the flexibility to retain the adult Medicaid coverage expansion and federal matching percentage.”

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