Study: Medicaid opt-out leaves 18,427 patients in need

A new study conducted by the American Mental Health Counselors Association shows more than 18,000 Louisianians with mental health issues were unable to receive treatment in 2014 as a result of Gov. Bobby Jindal opting out of a Medicaid expansion.

"Untreated mental illness or conditions that would have been prevented lead to more emergency department visits, hospitalizations, school failures, incarcerations and suicides — and increases overall health care costs," the study states. "Health insurance is the passkey to accessing consistent, quality mental health services and promotes recovery."

The 18,427 Louisiana residents who would have accessed mental health treatment if they had coverage made up part of a nationwide number of 568,886 people between the ages of 18-64 who lived in states that opted out of Medicaid expansion.

Monteic Sizer, who serves as executive director of the Northeast Delta Human Services Authority, said letting mental health issues go untreated causes a huge burden on society.

"As you know, mental illness is a disease," he said. "Like any disease, if left untreated, it becomes more expensive to treat. If not treated, mental illness will eventually impact all of our social systems influencing the family, education, justice and health systems. Those costs will exponentially increase. We must deal with this issue in a very comprehensive, coordinated way."

As a result of the Affordable Care Act, states were required to expand their Medicaid coverage with the federal government picking up the cost for the first three years. Later, the U.S. Supreme Court ruled states could opt out of the expansion.

Sizer said the costs could strain rural law enforcement agencies.

"If say that somebody has a mental illness in Tensas Parish and the police department is called at 3 o'clock in the morning. If no facility is available, they will typically transport that person to the local emergency room. If that local emergency room is not equipped to handle mental health services, that emergency room (will not have the ability) to serve the type of care that person needs.

"For the limited officers that rural communities will have employed, when they have to take and transport, that's one less officer available for a criminal call. The cost of a transport for a rural police force can be significant."

State Sen. Francis Thompson, D-Delhi, said Jindal needs to accept the Medicaid expansion to help curtail these issues.

"We have an obligation to take care of the needy people," he said. "These are people that work. They're the working poor. I want to make sure everybody is afforded health care. Through this opportunity, we're missing the boat. It's really a cost to us. That's why almost every other state has taken it."

Jindal officials, however, contend the state is able to serve all those in need.

"Our people have access to quality, around the clock mental health treatment through the state's Behavioral Health Partnership in Louisiana — we don't need an outdated, broken entitlement program like Obamacare to provide these services," Jindal spokeswoman Shannon Bates Dirmann said.

"This is possible because we've made substantial investments in mental health care access over the last seven years, and as a result the state's Behavioral Health Partnership is now providing more access to services and inpatient care than was available in the years before the program. In total, the number of providers has nearly doubled — from 800 to 1,700 — and the number of specialty service options through these providers has increased to over 5,000."

Jindal believes the Medicaid expansion is bad for Louisiana. "It will cost Louisiana taxpayers more than $2 billion over 10 years and could divert more than 250,000 people from private insurance into an outdated, inefficient system. It also prioritizes able-bodied adults over those with disabilities. It doesn't make sense for Louisiana."

The study states that the mental health field is on the cusp of improvements in access to treatment.

"The mental health landscape is on the threshold of major opportunities and changes that include new relationships between the medical and mental health sectors that potentially can bring access and improved services for many of our most disadvantages citizens who suffer from mental illness," the study states. "Medicaid expansion provides new opportunities to bring access to evidence-based practices to more people with mental health disorders who can benefit from such practices."

Thompson said the issue is too big to ignore.

"I think it's too big and too important to not realize that this state needs those federal dollars and the services are needed by the people of this state," he said.

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