Expanding NC Medicaid would improve care for mental illness and substance use disorders

“Without mental health, there is no health. Without access to addiction treatment, recovery will be out of reach for many.”

These words are from Chuck Ingoglia, president of the National Council for Behavioral Health. We know that people can and do recover from mental illness and substance use disorders provided they have access to the right treatment. In North Carolina, there is a massive disparity in the resources available to people covered by Medicaid compared to those who are uninsured. A practical way to address this disparity is to close the healthcare coverage gap by expanding Medicaid in our state.

At Alliance Health, which manages behavioral healthcare (BH) for people who are uninsured or are insured by Medicaid, it has been a challenge to meet the needs of both populations, which are equivalent in number. In 2019 we served around 46,000 Medicaid recipients but only around 18,400 uninsured individuals. Why the difference? Simply the amount of money available to provide services. As a practicing psychiatrist and forensic examiner, it is disheartening to so frequently encounter individuals experiencing mental health conditions whose needs go unmet — sometimes with tragic consequences — because funding for adequate treatment resources is insufficient.

Public health plans like Alliance receive a limited amount of state funds to pay for treatment for the uninsured. We utilize these restricted resources strategically, but the treatment available to the uninsured does not compare to the array of BH services available through Medicaid. When people cannot get the BH care they need, their conditions often explode into full-blown crises resulting in unnecessary emergency department visits, police involvement, and homelessness — scenarios that are traumatic and expensive for our families and communities.

Access to BH services is critical to successfully fighting the opioid crisis that has ravaged North Carolina. Almost half of those presenting in North Carolina hospital emergency departments for an opioid overdose are uninsured. By closing the Medicaid coverage gap, many individuals who are uninsured today would have access to proven treatments and rehabilitation. Medicaid-funded treatment can return productive individuals to their families and communities and offset a variety of expensive societal costs related to this cruel epidemic.

While the issue of Medicaid expansion has become a political football, Alliance views the matter as a simple access to care issue. Enhancing Medicaid coverage means that more North Carolinians could tap into critical BH treatments, primary care and medications. This builds stronger, healthier, safer communities for us all. States that have boosted Medicaid coverage have experienced increases in access to care, declines in uninsured ED visits, and a variety of other positive economic impacts.

North Carolina is only as strong as its citizens. If people have access to the healthcare treatment they need, they will have better overall health, fewer chronic physical illnesses, and the ability to contribute positively to their communities. Closing this coverage gap would be a game-changer for hundreds of thousands of North Carolinians.

This story was originally published January 22, 2020 at 2:09 PM.