Medicaid Expansion Greatly Improves Access to Behavioral Health Services

States can greatly improve access to behavioral health services for residents by expanding Medicaid through the Affordable Care Act (ACA), according to a new report issued by HHS.

The report, “Benefits of Medicaid Expansion for Behavioral Health,” found that in 2014 (the most recent year for which data are available), nearly 2 million uninsured people with a mental illness or substance use disorder lived in states that hadn’t expanded Medicaid, and had incomes that would qualify them for Medicaid coverage if the program were expanded. People with behavioral health needs comprise 30% of all low-income uninsured people in these states, the report noted, but many will only get coverage for healthcare if the states they live in expand Medicaid.

“…Medicaid expansion is an important step states can take to address behavioral health needs, including serious mental illness and opioid and other substance use disorders," HHS Secretary Sylvia M. Burwell said in a statement

As of now, 30 states plus the District of Columbia have expanded Medicaid under the ACA. However, the 20 states that have not expanded Medicaid include many of the states that would that would benefit the most, HHS noted in the report. If these 20 states do not expand Medicaid this year, over 4 million of their citizens will not received health insurance coverage in 2016, an important component of which would include access to treatment for people with mental health and substance use disorders. The report estimated that 371,000 fewer people each year would experience depression if they had coverage for behavioral health.

The HHS report stated that during 2010 to 2014 period, 37.6 million US adults ages 18 to 64, had a mental illness and 19.2 million had a substance use disorder in the past year.

Several states that expanded Medicaid reported that they expected reductions in general funds that had to be allocated to the uninsured for treatment ranging from $7 million to $190 million in 2015; thus, these states were able to use their funds to meet other critical health and substance use disorder needs. States that have populations with better physical and mental health also have a more productive workforce, HHS noted, and greater employer savings from reduced absenteeism. Similarly, a population with better behavioral health translates to less homelessness and criminal justice costs.

The report’s authors surveyed evidence showing that the social consequences of untreated behavioral health conditions frequently extend far beyond the affected individual to include the family, employer, and larger community, making the issue of behavioral health treatment and access a top priority for many states.

“There is also compelling evidence of numerous other benefits associated with treatment of behavioral health disorders, such as reduced criminal justice costs,” the researchers concluded.