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Florida's Failure to Expand Medicaid Impacts People With Mental or Drug Problems

Last year Florida Gov. Rick Scott refused to expand Medicaid. On Monday, the U.S. Department of Health and Human Services revealed that more than 300,000 Floridians with mental health or substance abuse problems could have potentially benefited from such an expansion. (File photo/WUFT)
Last year Florida Gov. Rick Scott refused to expand Medicaid. On Monday, the U.S. Department of Health and Human Services revealed that more than 300,000 Floridians with mental health or substance abuse problems could have potentially benefited from such an expansion. (File photo/WUFT)

The U.S. Department of Health and Human Services released a report Monday which found that 1.9 million low-income uninsured people in 2014 with substance abuse disorders or mental illnesses live in 20 states that haven't expanded their Medicaid programs.

The report, which examined the behavioral health services state residents can receive from expanding Medicaid under the Affordable Care Act,  found that Florida has 309,000 low-income uninsured residents.

That makes it  second only to Texas' estimated 406,000 uninsured low-income residents. Overall, Florida had about 726,000 residents who were uninsured in 2014.

Last June, the Florida House of Representatives rejected a proposal to expand health care, using $18 billion in federal funds for hundreds of thousands of residents in a 72-41 vote.

To date, 30 states have expanded their Medicaid programs to include low-income adults under the Affordable Care Act. Louisiana will be the 31st state as it moves forward to expand Medicaid, said Vikki Wachino, the director of the Center for Medicaid and Children's Health Insurance Program Services.

"There is no doubt Medicaid expansions increase access to health care and benefits the state's economy," Wachino said in a conference call Monday.

During the conference, Wachino described the variety of benefits to states, including a reduction in hospital expenses, significant federal funding and an increase in residents receiving regular preventive care.

However, the goal of the report was to shed light on the importance of combating mental health and substance abuse through Medicaid expansion.

For low-income individuals with serious mental illnesses, according to the report, treatment was 30 percent greater for those enrolled in Medicaid.

About 15 percent of Floridians are receiving treatment for a mental illness or substance abuse disorder, but only 8.8 percent of the total uninsured population, about 91,000 people, are receiving treatment, according to the report.

As for the cost to states, Richard Frank, the assistant secretary for planning and evaluation for the HHS, said there is a significant decline in uncompensated care provided by hospitals.

Because patients with mental health and substance abuse disorders tend to be disproportionately uninsured, they contribute to the uncompensated care amount, he said.

The report concluded by providing other external benefits to expanding Medicaid, citing reductions in homelessness and criminal justice costs and an increase in employment productivity.

"If states are serious about addressing mental illness, opioid and other substance use disorders, expanding Medicaid offers a unique opportunity to do so," Frank said.

Aaron is a reporter for WUFT News. Reach him by calling 352-392-6397 or emailing news@wuft.org.