The White House is pushing for Medicaid expansion under Obamacare in a new report released Monday in order to address the current opioid crisis and the lack of access to behavioral health services in the United States. Advocates, however, believe that other healthcare barriers need to be confronted as well.
At least 1.9 million people in the country with substance abuse and mental health disorders are uninsured because they live in states that have not yet expanded Medicaid under the Affordable Care Act, even though the residents have incomes that qualify them for coverage.
In the report [PDF], the Health and Human Services (HHS) department cited that if all states allowed Medicaid expansion, the coverage would result to an estimated 371,000 fewer cases of people with depression, and 540,000 more people would be in good health annually.
Richard Frank of HHS said if states are serious about tackling the opioid crisis and mental illness issues, expanding Medicaid provides a "unique opportunity" to do so.
Frank, who is an evaluation and planning assistant secretary of the HHS, said that by giving people with mental health disorders and substance abuse an easy door into treatment, they will be given a chance at improving their productivity and their overall life quality.
To date, the District of Columbia and 30 other states have exercised the option to expand Medicaid, extending the coverage to those making up the 138 percent of the federal poverty level.
Access To Insurance And Access To Treatment
Experts suppose that when people are covered by insurance, they will be more likely to see a doctor and more easily afford treatment.
But advocates said the report failed to take into account numerous other barriers that prevent people from accessing these treatments. This includes the shortage of available providers, as well as the difficulty of connecting those with mental health and substance abuse disorders to treatment that actually works for them.
Theresa Nguyen of Mental Health America said the group believes that Medicaid expansion is going to help a great deal.
"Access to any insurance will move people's barriers," said Nguyen, who is senior director of policy and programming. "But we've been saying for a while that access to insurance does not mean access to treatment."
Mental Health America releases an annual report called "State of Mental Health In America." In 2015, the report revealed that states differ significantly in whether they have any kind of mental health provider who can work with patients.
The availability of mental health providers fluctuates across America. Some states only cater 250 patients per provider, while others cater 1,100 per provider. Additionally, statistics from the HHS indicated that 55 percent of counties in the country, majority of which are rural, do not have practicing psychologists, psychiatrists, or social workers.
Nguyen said getting adequate treatment could take years. The process would involve recognizing the mental health condition to nailing down what kind of therapy or medication works best for the individual.
What's more, some providers accept only cash, ignoring Medicaid reimbursement and private insurance. Nguyen said this indicates that even when patients want to get treatment, the barriers are "so profound" that care is inaccessible.
Meanwhile, she said expanding Medicaid is only the first step because the government only begins to touch upon long-term systemic barriers to healthcare access.
"That is a parallel — if not a larger — systemic problem we are going to have to address if we are going to talk about helping people with a mental health problem," added Nguyen.
Photo: Texas Impact | Flickr