Politics & Government

Medicaid expansion would increase mental illness treatment, feds says

A federal report contends the state could help more people with mental illnesses and addictions by expanding Medicaid.

North Carolina has rejected Medicaid expansion, which would provide government health insurance to 300,000 to 500,000 low-income adults. About 1.9 million North Carolinians use Medicaid. The government health insurance covers low-income children and some of their parents, elderly people, and people with disabilities. The state and federal government share the $14 billion cost, with the federal government paying about two-thirds.

According to the report, in 2014 about 144,000 North Carolinians who were uninsured but would have been eligible for Medicaid under an expansion had a mental illness or substance abuse disorder.

If states are serious about addressing mental illness and treating opioid addiction, “expanding Medicaid offers a unique opportunity to do so,” Richard Frank, assistant secretary for planning and evaluation at the U.S. Department of Health and Human Services, said in a conference call with reporters.

The federal government pays the full cost of covering people under expansion for the first three years, with the state gradually taking on part of the cost until the state pays 10 percent.

Thirty-one states have expanded Medicaid. The U.S. Department of Health and Human Services on Monday released a report focused on states that had not expanded and their populations of uninsured people reporting mental illnesses or addictions.

Expanding Medicaid would make it easier for people with mental illnesses to get treatment, increase worker productivity, and save the state money, the report said.

States that expanded “no longer needed to use some of their general funds to pay for behavioral health treatment for the uninsured,” the report said.

Gov. Pat McCrory has appointed a task force on mental health and substance use, but Medicaid expansion is not on its list of policy proposals.

Last year, McCrory appeared to be interested in some form of Medicaid expansion, but said President Obama did not approve of the conditions McCrory wanted.

Questioned about expansion Monday, McCrory reiterated that position, adding he was most interested in expansion for specific categories of people.

"I’ve asked the President in the Oval Office whether or not he’d consider a work or training requirement if we’d consider an expansion of Medicaid, and the President has refused to consider a work or training requirement for Medicaid expansion,” McCrory said. “I’m most interested in Medicaid expansion for a more targeted audience, especially those with Alzheimer’s and also those with other diseases where they cannot help themselves. Those are the people I’m most interested in helping at this point in time."

Lynn Bonner: 919-829-4821, @Lynn_Bonner

Colin Campbell contributed.