HHS wants to capitalize on bipartisan interest to address opioid addiction and lack of access to behavioral health services by releasing a new report that shows Medicaid expansion could address the crises. The goal is to convince Republican holdout states to expand coverage.
An estimated 1.9 million uninsured people with a mental illness or substance use disorder live in states that have not yet expanded Medicaid under the Affordable Care Act and had incomes that could qualify them for coverage, according to the report released Monday.
The report found that if all states expanded Medicaid, an estimated 371,000 fewer people each year would experience depression, and 540,000 more people would report being in good or excellent health.
To date, 30 states and the District of Columbia have expanded Medicaid under the Affordable Care Act.
On a call with reporters Monday, a senior HHS official admitted that recent bipartisan interest in addressing mental health woes and substance abuse epidemics played some part in releasing the report.
“We thought it was good time to inject some new facts into that discussion,” said Richard Frank, assistant secretary for planning and evaluation at HHS.
Earlier this month, the Senate passed, 94-1, a bill aimed at combating opioid misuse and overdose deaths. The bill creates grant programs for states to build education programs, develop evidence-based treatment plans and strengthen prescription-monitoring programs. It also expands the availability of naloxone, which can reverse an opioid overdose.
However, Democrats said that without funding, the legislation is essentially powerless. The White House made a similar assertion.
And HHS' own data shows Medicaid expansion is not a silver bullet as some behavioral health providers are unwilling to take any insurance, especially Medicaid.
For instance, a 2014 JAMA Psychiatry study posted on the National Institutes of Health's website showed that psychiatrists' Medicaid acceptance rates, at 43%, were lower than physicians of other specialties, who came in at 73%.
Just last month, the CMS released a report that found Medicaid enrollees were not getting the behavioral care they needed, noting that the results “suggest that states have substantial room for improvement.”
A CMS spokesman countered that there is also positive data about Medicaid beneficiaries getting the behavioral care they need.
A 2015 American Journal of Public Health study found that low-income adults with serious mental illness are 30% more likely to receive treatment if they have Medicaid coverage.
He also pointed to a 2015 Government Accountability Office report, which found that Medicaid expansion states reported greater access to behavioral health treatment.
Officials in Nevada noted that there were fewer delays in receiving care, and officials in West Virginia reported an increased availability of prescription drugs for individuals with behavioral health conditions.