A national report released Monday details how many citizens with mental health issues in non-Medicaid expansion states are going without health insurance.
Nineteen states, including Missouri, have not expanded their Medicaid systems, opting out of increasing their federal poverty level (FPL) percentage in order to receive federal health care funding. To expand Medicaid under the Affordable Care Act (nicknamed Obamacare), states must pass legislation to boost their FPLs to 138 percent. Missouri's FPL is 19 percent for adults with dependents, and children are covered at 300 percent - the state's highest FPL guideline. Childless adults cannot receive any Medicaid services.
The new U.S. Department of Health and Human Services' report shows that 34.2 percent of Missourians who fall into the health care coverage gap have a mental illness and/or substance abuse disorder. They do not qualify for Medicaid, but cannot afford health insurance through their employers or the federal marketplace. This means that 91,000 of 976,000 Missourians with a mental illness or substance abuse disorder are without insurance and could benefit with Medicaid expansion, according to the report.
In the Show-Me State, the uninsured receive mental health treatment less than those with insurance. Of Missouri's uninsured population, 15.8 percent are being treated - compared to 18.5 percent who are insured. Among non-expansion states, those figures are 11.5 percent and 16.4 percent, respectively.
If Missouri were to expand Medicaid, the report states, 17,000 fewer Missourians would experience symptoms of depression, the mental illness affecting the most Americans at 7 percent of the adult population at any time. The report also claims 25,000 more Missourians would say they are in good, very good or excellent health if the state expanded Medicaid.
State Sen. Kurt Schaefer, R-Columbia, said in a news conference earlier this month that Medicaid costs skyrocketed to the price tag of $370 million to $395 million. There are about 100,000 more people on the system now, he said, than this time last year. Medicaid spending will be at the center of this week's budget debate in the Senate.
"All of these increased costs are costs to continue caseload growth, which occurs under the existing eligibility level," he said. "So, had we done expansion under Obamacare, it would not provide any relief from that statistic. In fact, it would cost us an additional $250 million for our share of the additional strata, that would go above the existing population."
Gov. Jay Nixon says the Legislature is facing budget problems because it hasn't expanded Medicaid.
"But all of this is within that context that, for the last three years, we've been turning down 100 percent federal money that we could, clearly, show additional resources to the state," he said. "When you're turning down $6 billion and you're complaining that you don't have enough money to pay for something?"