The Affordable Care Act (ACA), also known as Obamacare, provides for expanded Medicaid coverage for low-income Americans. So far, 36 states and the District of Columbia have adopted Medicaid expansion.
Current State of U.S. Medicaid Expansion
ACA offers financial incentives for adopting the Medicaid expansion, but courts have ruled that the decision to expand Medicaid is still up to individual states. There is no deadline, so states that have chosen to increase Medicaid eligibility are at varying stages of program expansion.
Idaho, as of May 2019, is waiting for the federal government to accept the state’s voter-approved plan to expand Medicaid eligibility. If approved, Medicaid coverage for Idaho residents will start in 2020. Earlier this year, however, state lawmakers passed work requirements and other restrictions that may cause delays.
North Carolina is currently debating Medicaid expansion, with Gov. Roy Cooper meeting with healthcare leaders who support the effort. Proponents argue that expanding coverage would increase care opportunities for state residents, add healthcare jobs, and support rural hospitals. A bill introduced in the state House would provide an alternative to Medicaid expansion. This would help close the state’s coverage gap at a lower cost by requiring program participants to work and pay premiums.
Virginia has expanded Medicaid coverage, with enrollment beginning January 1, 2019. Although the state expected about 200,000 people to enroll in the first six months, about 277,000 adults have already enrolled.
How State Decisions Affect Behavioral Health and Addiction Treatment
One concern surrounding Medicaid coverage is the potential for expanded access to behavioral health services. How is Medicaid expansion affecting some states’ behavioral health services?
Idaho’s nine community recovery centers for addiction and mental illness are financially vulnerable. The centers’ request for funding under the Idaho Millennium Fund was not included in Gov. Brad Little’s fiscal 2020 budget recommendation. Little intends to use the fund for the state’s Medicaid expansion. Medicaid expansion could increase access to behavioral health services, but recovery centers may not survive without state funding.
In Virginia, a study by Virginia Commonwealth University (VCU) examined the prevalence of substance use disorder among uninsured Virginians and newly eligible Medicaid members. Researchers found that opioid prescriptions declined among members, and more of them are receiving co-prescriptions for the opioid antagonist naloxone. Virginia is “well prepared” to manage the increased need of addiction treatment services due to Medicaid expansion, says Peter Cunningham, PhD, a professor at VCU School of Medicine’s Department of Health Behavior and Policy.
North Carolina last year received federal approval of a Section 1115 waiver to provide financing for Healthy Opportunities Pilots, a new pilot program to cover evidence-based, non-medical services to target social needs that can affect health. The program addresses housing, transportation, and food insecurities, as well as interpersonal violence and toxic stress.
Prepare for Expanded Behavioral Health Services
Behavioral health and addiction treatment providers may see greater demand in states that expand Medicaid or receive Section 1115 waivers. A comprehensive EHR solution can help you keep up with demand while streamlining services.
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