In the wake of last December’s shooting massacre in Newtown, CT, many conservative lawmakers and state leaders called for strengthening America’s broken mental health care system. But now, the GOP’s stubborn opposition to Obamacare’s Medicaid expansion is preventing 1.2 million poor and mentally ill Americans from getting basic mental services, according to an analysis by the National Alliance on Mental Illness (NAMI).
Republican politicians have argued extensively for shoring up the U.S. mental health regimen to prevent future shootings. Rep. Louie Gohmert (R-TX) said that mental health issues have “languished” for decades, and that the two parties can easily come together to fix them. Sen. Ted Cruz (R-TX) voted against the compromise Manchin-Toomey background check bill, offering alternative legislation focused on school security and mental health resources. Florida Rep. Ander Crenshaw (R) also cited mental health services as an important part of addressing gun violence, as did Sen. Marco Rubio (R-FL), who signed onto Cruz’s gun safety bill.
Despite their professed zeal for making the U.S. mental health regimen stronger, however, these members of Congress don’t support the programs like Obamacare’s Medicaid expansion that could actually help ensure Americans’ access to those benefits. Crenshaw co-signed a letter with fellow anti-Obamacare Florida legislators in which he suggested that expanding Medicaid would be fiscally irresponsible. Cruz, Rubio, and Gohmert are all adamantly opposed to Medicaid expansion and the health law at large.
That amounts to denying essential health care to millions of poor and sick Americans, according to the NAMI study. The Substance Abuse and Mental Health Services Administration (SAMHSA) found that 2.7 million uninsured Americans with mental disorders such as depression, anxiety, schizophrenia, or bipolar disorder would qualify for Medicaid and its mental health benefits if all states took part in the expansion. NAMI estimates that a third of all low-income Americans who would be added to expanded Medicaid rolls suffer from a mental illness.
By opposing federal Medicaid funding from Obamacare, these lawmakers and GOP-led states who refused expansion are putting the burden of reform onto state governments that have proven inept at fixing their dysfunctional mental health care systems. These states feature the lowest per-capita mental health spending in the country — as low as $75 per person in some cases. That simply isn’t enough to cover the cost of mental health treatment.
Several Republican governors in anti-expansion states told Mother Jones that they were sticking by their calls to expand mental health funding in the wake of the Sandy Hook shooting massacre. Govs. Scott Walker (WI) and Mary Fallin (OK) argued that they are including millions of extra dollars for mental health care programs in their budgets.
But without Obamacare and its Medicaid expansion, those funds won’t go very far — and they pale in comparison to the amount of federal money that states would get under Medicaid expansion. That’s because Medicaid is by far the most important source of funding for mental health care, with federal and state Medicaid funds making up 46 percent of a state’s mental health budget. Consequently, the health reform law is the largest expansion of mental health care services passed since the creation of Medicaid itself.
Studies have already shown that states refusing to expand Medicaid will lose out on $8 billion in federal funding. That’s money that won’t be going to treating poor Americans’ mental illnesses, leaving them to either consume expensive and inefficient emergency room care, or to languish in prisons that are becoming de-facto asylums in the face of health care budget cuts.