EDITORIAL: Medicaid expansion helps mentally ill

March 28--Gov. Sam Brownback has been talking recently about the need to provide better care for the mentally ill. But if he really wants to help, he should stop blocking the federal expansion of Medicaid, which would enable thousands of Kansans to receive mental health treatment in their communities.

To his credit, Brownback has acknowledged that the state isn't doing enough to care for the mentally ill. At a recent event in Topeka organized by mental health advocates, he noted that too much of that care is occurring in the state's correctional system.

"We've got to do a better job," he said.

Brownback also highlighted how his administration is working to increase the coordination among the state's 27 community mental health centers and has reconfigured the Rainbow Mental Health Facility in Kansas City, Kan. A Brownback-appointed task force is working on other possible improvements to the state's mental health system.

Better coordination and system improvements are needed. But so is more funding and expanded access to care.

About 65,000 people receiving services from the community mental health centers are not currently eligible for Medicaid, according to the Kansas Mental Health Coalition. Many of them would qualify for Medicaid under the federal expansion.

"Seventy percent of the people being treated at one of the community mental health centers are making less than $20,000 a year," Sean Gatewood, a spokesman for the Kansas Medicaid Access Coalition, told the Kansas Health Institute News Service. "And 53 percent are uninsured, which means they're poor but they're not poor enough to be on Medicaid. These are the people that, clearly, Medicaid expansion would benefit."

There is also a high cost in not expanding Medicaid. In Kansas, untreated mental illness is associated with an estimated 128 suicides, 21,000 incarcerations and 29,000 unemployed adults per year, costing the private sector nearly $429 million, according to the Kansas Mental Health Coalition.

Brownback has resisted expansion, saying that he isn't confident the federal government will honor its promise to pay for all of the cost for the first three years and nearly all of it after that. More recently, he has said he wants to focus on eliminating the state's waiting list of Kansans with disabilities needing services.

At the Topeka event, Finn Bullers, an activist for the disabled, challenged Brownback's unwillingness to expand Medicaid.

"He makes a wonderful speech," Bullers said. "But when the rubber meets the road, the money isn't there now. And when the money isn't there, the services don't get provided."

The governor assured mental health advocates that he shared many of their concerns. "The hallmark of a compassionate society is to help people who need help," he said.

The best way for Brownback to help people and show compassion is to expand Medicaid.

For the editorial board, Phillip Brownlee

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