Guest Opinion: Medicaid Expansion Will Help Idahoans with Mental Illness

Implementing the will of Idaho voters improves care for Idahoans with mental illness

Guest opinion: Jim Baugh, Executive Director of DisAbility Rights Idaho

After six years of seeking a solution to Idaho’s healthcare coverage gap, the legislature has a chance to implement full Medicaid expansion with sixty percent of Idaho voters behind them. After forty years advocating for people with disabilities, including mental illness, I see this as an historic opportunity to improve Idaho’s struggling mental health service system.

On Nov.6, Idahoans voted overwhelmingly to expand Medicaid to Idahoans in households up to 138 percent of the federal poverty level. Now the Legislature’s role is to appropriate Idaho’s ten percent share of the cost. An estimated 62,000 Idahoans currently in the insurance gap will finally get coverage, including at least 20,000 with a serious mental illness.

Despite the clear mandate from Idaho voters, some legislators are proposing restrictions that will create barriers to coverage. If the Legislature passes measures making it more difficult to qualify for Medicaid, Idaho taxpayers will bear the administrative and legal expense of implementing those requirements. Bureaucratic red tape, designed to restrict access to Medicaid, will actually diminish or eliminate the savings projected for the state. People who can’t get coverage will continue to incur health care costs that are passed on to the state and the counties through the indigent health care program, and to the rest of us in the form of higher premiums.

Medicaid expansion has the potential to make an array of mental health treatments and services available to Idahoans who struggle with persistent mental illness. These Idahoans are currently without coverage and cannot get mental health services until they are in crisis. Access to ongoing treatment and supports can prevent those crises and keep them out of our emergency departments, hospitals and even our jails. However, living with a chronic mental illness or substance use disorder is especially demanding, and filling out forms and reports and dealing with red tape to overcome restrictions on eligibility is especially hard for these people. The ability to hold a job can depend on consistent access to treatment and affordable prescription medication. Even then, their ability to work may be intermittent. When health coverage is taken away, complications from behavioral health conditions can get worse and eventually lead to crisis.

For people with mental illness, access to medical and mental health care is critical to stability and independence. Medicaid services, like psychiatric rehabilitation, can target skills needed for a return to work. Medicaid coverage for people with behavioral health conditions can help them achieve greater independence, including employment. To promote employment and independence for people with disabilities we need to make Medicaid coverage readily available to them. Work reporting, drug screening and other barriers make coverage more difficult to obtain.

Fully funding and implementing a simple and straightforward version of Medicaid expansion is the right thing to do for Idaho. Increased access to preventive care and rehabilitation programs is a fiscally responsible solution, which will allow Idahoans with behavioral health conditions to tap into their potential and care for themselves, their families and their community.

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