Medicaid expansion would help with mental illness, substance abuse, federal report says
There are an estimated 726,000 Floridians without health insurance who have a mental illness or substance abuse disorder.
And expanding Medicaid could put a serious dent in that number, cutting it almost in half, according to the federal government, which on Monday released a report citing the impact of expansion on state behavioral health programs.
“If states are serious about addressing mental illness, opioids and other substance abuse disorders, expanding Medicaid will provide them a unique opportunity,” said Richard Frank, assistant secretary for planning and evaluation with the U.S. Department of Health and Human Services.
Florida is one of 29 states that has not opted in to Medicaid expansion. Last year, the Florida House voted down a proposal to do so.
Opponents in the House and Gov. Rick Scott argued that the state would be on the hook to pay for health coverage far down the road when federal money to subsidize the program might not be a guarantee.
Under the Affordable Care Act, the federal government would cover the full cost of expansion through this year and gradually decrease its support to 90 percent in 2020. President Barack Obama has proposed funding 100 percent of the cost for the first three years in any that expands Medicaid.
Mental health and substance abuse, however, have been central to the Legislature's agenda recently. Lawmakers this year passed sweeping changes to the state's mental health system.
Despite long-term impact on states’ budgets through a larger Medicaid program, federal officials argue that expanding Medicaid would save states money in other parts of their budget.
“More generally, we know that states that expand Medicaid can achieve significant improvements with their behavioral health programs without incurring additional costs,” said Vikki Wachino, director for the Center for Medicaid and CHIP Services.
For example, Florida’s prison chief, Julie Jones, estimated last year that 40 percent of the state’s inmates have some sort of mental illness. And much of the money in Florida’s mental health budget is spent on the state’s mental hospitals, some of the most expensive patients.
Expanding Medicaid, the HHS report says, could help low-income people who need help find treatment before problems become more severe. That means they could work and decrease the risk of becoming homeless or incarcerated.
What’s more, according to the report, as many as 100,000 people could report positive health and 69,000 fewer people could suffer from depression.
“Yes there are budgetary impacts in long run,” Frank said. “But there are huge human gains, huge economic gains as a result of expanding.”