On March 28, 2016 the Department of Health and Human Services published a brief on the benefits of Medicaid expansion for mental health and substance use disorder drafted by the Assistant Secretary for Planning and Evaluation. An excerpt of that brief is published below and the full brief can be found here: https://aspe.hhs.gov/pdf-report/benefits-medicaid-expansion-behavioral-health
By: Judith Dey, Emily Rosenoff and Kristina West (ASPE); Mir M. Ali, Sean Lynch, Chandler McClellan, Ryan Mutter, Lisa Patton, Judith Teich and Albert Woodward (SAMHSA)
Across the country, state and local officials are increasingly focused on improving health outcomes for people living with mental illness or substance use disorders. This brief analyzes national data on behavioral health and reviews published research focused on how Medicaid expansion under the Affordable Care Act advances the goal of improving treatment for people with behavioral health needs. The key findings are the following:
- Many of those who could benefit from Medicaid expansion have behavioral health needs. In 2014, an estimated 1.9 million low-income uninsured people with a substance use disorder or a mental illness lived in states that have not yet expanded Medicaid under the Affordable Care Act. In addition, people with behavioral health needs make up a substantial share of all low-income uninsured individuals in these states: 28%. While some of these individuals had access to some source of health insurance in 2014, many will gain access to coverage only if their states expand Medicaid, and others would gain access to more affordable coverage.
- In states that have not yet expanded, Medicaid expansion would provide considerable benefits for individuals with behavioral health needs and their communities. Among low-income adults, Medicaid expansion is associated with a reduction in unmet need for mental health and substance use disorder treatment. For example, one study estimates that low-income adults with serious mental illness are 30% more likely to receive treatment if they have Medicaid coverage. This will be especially important to states as they work to address opioid use disorder and serious mental illness.
- Access to appropriate treatment results in better health outcomes. For example, projections based on experimental research on the effects of Medicaid coverage expansions suggest that if the remaining states expanded Medicaid, there would be 371,000 fewer people experiencing symptoms of depression.
- States that choose to expand Medicaid may achieve significant improvement in their behavioral health programs without incurring new costs. State funds that currently directly support behavioral health care treatment for people who are uninsured but would gain coverage under expansion may become available for other behavioral health investments.
- Medicaid expansion also reduces costs that are incurred by state and local governments and state economies as a consequence of behavioral health problems. In addition to improving quality of life for individuals, treating behavioral health conditions has been shown to reduce rates of disability, increase employment productivity, and decrease criminal justice costs.