Montana is in the midst of a substance use disorder and mental health crisis. The evidence is all around us, from the latest youth suicide report, increased homelessness in towns, increased involuntary commitments, or news of drug overdoses.
This is undoubtedly a complicated and urgent crisis, but it is not without solutions.
Our state is at a critical juncture to decide the future of Medicaid expansion. In addition to providing access to important physical health care services, Medicaid expansion has been an invaluable tool for Montana to provide unprecedented access to mental health and substance use disorder treatment services in the past three years.
Since Medicaid expansion passed, nearly 100,000 Montanans have gained access to health coverage. According to the Department of Health and Human Services, nearly 10,000 adults have received substance use outpatient or inpatient services and about 35,000 adults have been able to access mental health care services.
The Behavioral Health Alliance of Montana, with almost 30 mental health and substance use disorder treatment service providers, knows one of the most effective ways to respond to the epidemic is to make Medicaid expansion permanent. The HELP Act must be reauthorized to ensure that the people we treat have access to high-quality health care.
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However, there are talks of changing this successful program that make us worried. The changes we are concerned about include unnecessary, strict reporting requirements in order to maintain coverage. Proposals to take health care away from people who do not meet stringent work and reporting requirements jeopardize Montana’s rural communities and Indian Country, where Medicaid is an important source of coverage to communities facing high barriers to care and unemployment rates. Mental health and substance use disorder treatment has already been drastically reduced in rural areas due to the statewide budget cuts last year.
The urgent need to make sure people have access to behavioral health care is real. Medicaid spending on substance use disorders has increased five-fold from 2015 to 2017, most of which is new federal funds, as more people are able to get the care they need. Expansion is the most cost-effective way that we can ensure Montanans have access to the help they need to manage mental health issues and to successfully recover from addiction.
Mental health and substance use disorder treatment service providers across the state have seen the life-changing impacts of Medicaid expansion. We will tell you time and time again that if Medicaid expansion were repealed or if the legislature imposed new, strict requirements on enrollees, that our state’s progress and ability to successfully meet the behavioral health needs of Montanans would be rolled back five to 10 years. In addition, many of the providers will be unable to keep their doors open as reimbursements has been severely reduced.
The people who work in this field every day — therapists, mental health providers, licensed addiction counselors and community service providers — will tell you the same thing: there is no viable solution to address the mental health and substance use crisis in our state without Medicaid expansion.
We call on legislators to make the right choice for Montana and the people we serve. Simply lift the sunset on a program that is working. Don’t punish Montanans because they need help. Giving them health care is the ticket to helping them live full lives and take part in our communities. It’s good for them, and it’s good for Montana.