Your Opinion: Proposal will aid mental health

Dear Editor:

As a mother of an adult son with developmental disabilities and a Missouri Mental Health commissioner, I believe it’s important for local citizens to understand clearly the debate on whether to extend Medicaid coverage in Missouri. Extending Medicaid has major implications for Missouri’s mental health system.

If Medicaid is extended, nearly 50,000 of the 300,000 newly eligible Missourians would receive services through the Department of Mental Health community treatment and support programs. Many will be young adults, between the ages of 18-30, with developing mental illnesses such as schizophrenia or bipolar disorder.

By extending Medicaid coverage, Missouri will get back $1.8 billion of its federal taxpayer dollars in each of the first three years, and $2 billion annually thereafter. A University of Missouri study says extending Medicaid generates 22,000 new jobs for the state in health care professions. It will also reduce the number of individuals who seek health care through hospital emergency rooms.

However, just as there are benefits to the public mental health system by extending Medicaid coverage, there are dangers for the system if it is not extended. To help fund the Medicaid expansion, federal dollars, called Disproportionate Share Hospital payments, will be reduced by 50 percent. These funds cover charity care for indigent hospital patients. Hospitals that lose those payments will have to make up for that loss by cutting services to places like psychiatric units, which have the highest percentage of indigent patients.

Missouri has already lost over 1,400 psychiatric hospital beds since 1990. This additional loss of psychiatric beds will also create greater problems for county and city law enforcement that transport patients, often long distances, in search of an available psychiatric bed. Local law enforcement officers stay at the emergency rooms and psychiatric units for hours as these patients are admitted into care. This situation will worsen.

Extending Medicaid in Missouri will help provide treatment earlier to people developing serious mental illness and substance use disorders; it will enhance public safety; and it will improve overall public health. Not extending Medicaid will have a significant, negative impact on Missouri’s mental health system, particularly in losing hundreds of psychiatric beds.

I encourage you to contact your local legislators to let them know the importance of extending Medicaid in Missouri.

Issue-oriented letters to the editor in response to this or about other local topics are welcome. All letters should be limited to 400 words. The author's name must appear with the letter, and the name, address and phone number provided for verification. Letters that cannot be verified by telephone will not be published. Send letters for publication to


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