About 406,000 uninsured Texans had a behavioral health condition in 2014 that could’ve been treated with insurance provided through the expansion of Medicaid or a federally-approved alternative, according to a new report from the U.S. Department of Health & Human Services.
The report, released on Monday, found that about a quarter—23.2 percent—of all low-income, uninsured Texas residents have a mental health need and would qualify for health insurance if the state would expand Medicaid under the Affordable Care Act. The state is among 20 that have refused to do so, losing out on about $90 billion over 10 years in federal dollars to pay for it.
The report is another nudge from the Obama administration for the largely conservative holdouts to expand the program. These affected individuals fall into what’s widely known as a coverage gap—they make too much to qualify for Medicaid, but not enough to qualify for subsidies on the exchange. They make less than 138 percent of the federal poverty rate: About $16,243 for a one-person household, $33,465 for four people. The report says there are 1.9 million of these Americans living in the 20 states and would have access to behavioral health services if their lawmakers expanded the program.
There are fears, even in the healthcare community, that the dwindling amount of physicians and providers who accept Medicaid patients would create a severe access issue. After all, merely having insurance does not mean that you’ll be able to be seen in a doctor’s office. Some states, like Indiana and Arkansas, have reached a mid-point with the feds—they’ve agreed to take the carrot, but on their own terms. Some of these plans include using their share of the federal dollars to subsidize private plans, bypassing Medicaid all together.