Repealing the Medicaid Expansion Will be a Disaster for People with Mental Health Problems

By Linda Rosenberg

We can’t leave people with mental health problems out in the cold. (iStock)

We can’t leave people with mental health problems out in the cold. (iStock)

Three years ago Chips Drake was unemployed, homeless and suffering from both physical and mental health issues.

Today it is different. Chips says his life changed when he received care through the Medicaid expansion. He got glasses and dentures: small things, but essential. He also received mental health care that helped him work through years of emotional issues. He got back on his feet, returning to school and completing his coursework for a master’s degree in professional counseling.

Now Chips, 58, works full-time for Hope Network, a mental health facility in Flint, Mich., and credits Healthy Michigan with making it possible for him to give back to others. Getting health care through the Medicaid expansion changed his life and the lives of the people he works with every day.

Chips and many others like him are why I went into the mental health field more than 40 years ago. The threat to the Affordable Care Act’s Medicaid expansion is the worst crisis I have seen in my four decades years on the ground supporting the improved delivery of mental health and substance use services.

In recent years, the National Council and our partners in the behavioral health field have made strides toward an America where everyone can get the health care they need, not just for their bodies, but for their minds, too. The Affordable Care Act’s Medicaid expansion helped 11 million people take better care of themselves, but as Congress considers changes to our health-care system, we cannot overlook what a success story the Medicaid expansion has been for people facing behavioral health issues, too.

Repealing the Medicaid expansion would leave millions of Americans with mental health problems in serious danger. In fact, Americans with mental health and substance-use disorders are the single largest beneficiaries of the Medicaid expansion under the Affordable Care Act. Nearly 1 in 3 people who receive health insurance coverage through the Medicaid expansion either have a mental illness, substance-use disorder or both. If the expansion is repealed, these 1.29 million vulnerable Americans will be left without access to lifesaving treatment.

In that case, states will lose an estimated $4.5 billion a year that currently goes to support addiction and mental-health treatment services for enrollees, money that cannot easily be replaced by states that are already struggling under revenue shortfalls and budget gaps. Removing access to mental-health care would also harm the employment prospects of people like Chip, who rely on treatment or medication to keep them well enough to go to work.

On top of that, repealing the Medicaid expansion would halt fledgling progress to combat the opioid epidemic because of the sheer number of people who get treatment for addictions through the ACA’s Medicaid expansion. Cutting spending for addiction treatment in the midst of a catastrophic drug crisis is shortsighted and dangerous.

As Democratic Ohio Sen. Sherrod Brown said, “Repealing the law would immediately interrupt treatment for hundreds of thousands of Ohioans who are struggling with addiction and fighting for their lives. Local communities all across Ohio are doing their part to combat the opioid crisis. We cannot let the federal government pull the rug out from under their work with so many lives at stake.”

The American Health Care Act is not the National Council’s vision for health care in America. The real result is that people will die.

Luckily, many are uniting — across party lines — to protect behavioral health and keep our promise to the millions of people like Chip.  The National Governor’s Association has called for Congress to ensure “a meaningful federal role” in financing Medicaid. In fact, sixteen of the states that broadened Medicaid eligibility are led by Republican governors who are standing for its continuation. That includes Michigan Gov. Rick Snyder, who said his state saw “a huge increase in coverage,” combined with a huge drop in the number of people showing up at hospitals without insurance — a financial burden that cost hospitals nationwide $50 billion in uncompensated care in 2013. Arizona Gov. Doug Ducey stood up for the 400,000 Arizonans covered as a result of the Medicaid expansion, with a clear message to Capitol Hill: “I don’t want to see any Arizonans have the rug pulled out from under them.” “I just want to know what’s going to happen to all those people who find themselves left out in the cold,” said Ohio Gov. John Kasich.

As Congress votes on these issues, they’re also voting on the hopes, dreams and lives of millions of Americans grappling with mental illnesses and addiction disorders. For all of them and for advocates like myself who have devoted their lives to caring for people struggling with these challenges, I hope our government doesn’t vote to abandon its most vulnerable citizens.

ROOT17: A Community Fête

Friday, April 28, 2017
6:00pm - 10:00pm
Rock Wall Wine Company
2301 Monarch Street Alameda, CA, 94501 United States


We’re thrilled to announce our 3rd annual ROOT event and invite you to join us at our high profile event on Friday, April 28, 2017! At Lincoln, we work every day to unlock the doors of possibility and rewrite the story of growing up in poverty and trauma. You play a vital role in this critical work. We invite you to join us at ROOT17 and join other community members investing in strengthening families and changing lives.

The fun begins with wine and signature bites prepared by some of the Bay Area’s finest chefs. Next: a family-style feast and exciting live auction. Plus, we’ve got a special surprise entertainment on tap. Once the sun goes down, the after party begins. Get ready to dance!