Twenty-five states have yet to adopt the Medicaid expansion under the Affordable Care Act. This Medicaid expansion was set to begin on Jan. 1 this year. The legislation expanded Medicaid coverage to cover adults earning up to 138 percent of the federal poverty level. For a household of four, 138 percent of that level is $32,499 annually.

The states that have not adopted the expansion are disproportionately in the Southeast and Mountain West states, according to the February 2014 report by the American Mental Health Counselors Association.

The states that have rejected the Medicaid expansion are clearly attempting to make a statement in opposition of the Affordable Care Act. However, the consequences for rejecting this expansion are vast, particularly for those with mental illnesses. Government funding for uninsured individuals is essential for the well-being of our society.

The Medicaid expansion took steps toward resolving the underfunding for mental health care and the growing issue of mental illnesses in the United States. The Affordable Care Act significantly expanded mental health coverage. In the past, mental health care has not received the same amount of attention as other health issues. It is essential that mental health care be considered as legitimate of an issue as physical ailments and diseases.

Putting political issues aside, states should be providing mental health care for uninsured Americans.

The February report reveals that by refusing to accept the Medicaid expansion program, 4 million uninsured people with a serious mental illness, in serious psychological distress or who have a substance use disorder will not get the coverage they need.  Ironically, 70 percent of uninsured individuals with a serious mental illness are residents of 11 of the southern states that have not adopted the Medicaid expansion, the report also showed.

The funds for the expansion have already been incorporated into the federal budget and the cost for the individual states is low, according to the report. Rejecting the expansion has serious consequences for uninsured Americans, particularly those who suffer from a mental illness.

It also brings up a more serious issue for those who are below the poverty line. People with serious mental illness are much more likely to fall into that category. For example, only 25 percent of people with schizophrenia are steadily employed. According to the American Mental Health Counselors Association, one in six adults who would qualify for the Medicaid expansion have a serious mental illness.

This is an issue because without preventive care, mental health issues are more likely to affect potential employment and socioeconomic mobility. By not getting the support they need, they continue to be unemployed and cost the government and society in other ways.

For all serious illnesses, preventative care is essential to avoid emergencies and other ramifications. Moderate mental health conditions can escalate into extreme circumstances that result in hospitalizations, homelessness or delinquency. Mental health issues can have far reaching effects on families, neighborhoods and communities. Preventative services minimize these effects and benefit many people.

Without comprehensive coverage, many who earn near or below the poverty line will not have access to preventative services because the states they live in refuse to be a part of the Affordable Care Act’s Medicaid expansion.

It is clear that addressing these issues early on is essential to limit the consequences of mental illness. By not adopting the Medicaid expansions, these 25 states are denying people necessary mental health care.

The magnitude of this is enormous. According to data released by the Substance Abuse and Mental Health Services Administration, 18.2 percent of American adults suffer from perpetual mental illness. It is clearly not an isolated issue that affects a select number of people. This issue deserves more attention than it has received and must be addressed.

Mental health issues are not only serious, but also widespread. Regardless of how states choose to fund mental health services, it is essential that uninsured individuals have access to preventive and emergency services.

Published on March 3, 2014 at 1:00 am