Officials Emphasize Drug Treatment, Mental Health in Medicaid Push

In its latest effort to get more states to states to expand their Medicaid programs, health officials are emphasizing its role in paying for treatment of opioid abuse and mental health issues.

Federal health officials are still pressing to get more states to agree to extend Medicaid eligibility to all low-income residents under the Obama health law, in the wake of a 2012 Supreme Court decision that effectively gave governors and state legislators a choice over whether to do so. To date, 30 states have opted in; 20 are sitting out.

In a report, the Department of Health and Human Services said Monday that there are around two million low-income, uninsured people in those 20 states who have a mental illness or substance abuse disorder.

“Today’s report shows that Medicaid expansion is an important step states can take to address behavioral health needs, including serious mental illness and opioid and other substance use disorders,” said HHS Secretary Sylvia Mathews Burwell.

The estimate was released on the eve of President Barack Obama’s visit to a prescription abuse conference in Atlanta. Opioid abuse is a rare area in health policy where there is bipartisan concern. Medicaid expansion, however, is less clear-cut.

Expanding Medicaid, federal officials argued, would extend health coverage to many people with an addiction or other mental illness. It could also cut down on states’ costs, in part because states currently directly fund some mental health treatments and would get more generous federal funding to grow their Medicaid programs.

Medicaid has long been a joint federal-state program that offers near-free care to the very poor. Under the health law, Washington pays almost all of the costs of insuring people who have slightly higher incomes.

Opponents of expansion argue that neither states nor the federal government can afford to further swell the program, and that a shortage of providers to treat the newly insured poses an additional challenge in trying to enroll more people in it.

To date, those arguments have prevailed in some states. Supporters of the health law had predicted most states would rush to take up the opportunity of Medicaid expansion, but that pace has largely slowed now and there are limited prospects for the  holdouts to change their minds before the president leaves office.

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