If the state expands its Medicaid program, more than 21,000 uninsured Kansans who are also known to be mentally ill would have access to the care they need, according to a report released today by the National Alliance on Metal Illness.
“Expanding Medicaid will help people living with a mental illness get back to work,” said Rick Cagan, executive director for NAMI Kansas. “It will help them recover and become more productive. It’s the most important step our state can take right now.”
In keeping with a U.S. Supreme Court ruling last year on the Affordable Care Act, states are not required to expand their Medicaid programs to include childless adults whose incomes fall below 138 percent of the federal poverty level, about $1,300 a month for one person. Instead, expansion is optional.
According to the NAMI report, 20 states and the District of Columbia have decided to expand their Medicaid eligibility, 14 states have rejected the notion. In 16 states, including Kansas, the decision is said to be “pending.”
Gov. Sam Brownback, an outspoken critic of the Affordable Care Act, also known as Obamacare, has said he continues to weigh the pros and cons – as well as the expense – of expanding Medicaid. He’s also said he doubts the federal government will be able to keep its promise to pay 100 percent of the expansion states’ costs through 2016; 95 percent in 2017, 94 percent in 2018, 93 percent in 2019, and 90 percent in 2020 and thereafter.
Brownback has said expanding Medicaid eligibility would likely cost the state an additional $600 million over 10 years.
Earlier this year, the House and Senate bolstered the governor’s reservations, adopting provisos opposed to expansion.
Cagan, however, countered that projections also show that expansion would generate an additional $5.3 billion in federal aid for Kansas over a 10-year period.
“That’s a significant source of revenue,” he said. “The fact of the matter is that, right now, the individuals we’re talking about here don’t have access to comprehensive mental health services because they’re uninsured. And that lack of access means that the chances of their living successful lives are greatly diminished. They’re stuck.”
According to the NAMI report, 13 percent of the uninsured adults in Kansas are known to have a mental illness.
Recent surveys also have found that 53 percent of the people receiving services through one of Kansas’ 27 community mental health centers are uninsured.
“I’d say that about half of that 53 percent would be eligible for Medicaid if the decision was made to expand Medicaid,” said Mike Hammond, executive director at the Association of Community Mental Health Centers of Kansas. “That’s a guess on my part. It could be more.”
Susan Crain Lewis, executive director with the Kansas City-based advocacy program, Mental Health America of the Heartland, said the number of uninsured adults who are mentally ill appears to be increasing.
“We get an awful lot of calls on our help hotline from people who for one reason or another either don’t have, can’t afford, or have lost their health insurance and are frantically seeking mental health treatment,” Lewis said. “Chances are they’ve already reached out to the mental health center, but the reality is that fewer and fewer services are available because so much of the funding has been cut.”
In the NAMI report, the authors argue that the mentally ill face “glaring gaps of treatment” that “would not be tolerated for heart disease, cancer or diabetes."
Carol Manning, chief executive at The Mental Health Association of South Central Kansas, agreed.
“When you step back and look at what’s available to people who have insurance and what’s available to those who don’t, there’s a real disparity,” Manning said. “It’s a disparity that really needs to be addressed.”