Uninsured Eligible for Mental Health Services

When major portions of the Affordable Care Act are implemented in 2014, almost all of the 500,000 uninsured Californians who were previously identified as being in need of mental health services will be eligible for those services, either through Medi-Cal expansion or the exchange, according to a study released yesterday by the UCLA Center for Health Policy Research.

“Last year we did a mental health report, and what we found is there are 500,000 or so people in California who are uninsured and in need of mental health services, so this year we wanted to see who among them would be eligible for coverage under the Affordable Care Act,” said Imelda Padilla-Frausto, lead author of the report released yesterday.

“We found about half of them would be eligible through expansion, and another 42% through the exchange,” Padilla-Frausto said. “That’s practically everyone. It’s a huge improvement for those adults who don’t have insurance coverage.”

About 10% of the uninsured adults needing mental health services from last year’s report will be ineligible for coverage under the ACA due to citizenship status, Padilla-Frausto said. Undocumented  immigrants are not eleigible for benefits under the ACA.

You can lead childless adults to health care coverage, Padilla-Frausto said, but you can’t make them use it.

“We can’t estimate how many of the ones who are eligible will actually utilize those services,” she said. “Our data show that, among people who need services, generally about half of them utilize those services.” With mental health utilization there is an added factor, because of the stigma of seeking and using mental health services, she said.

“There’s a barrier to use those services, there are personal issues of not wanting to access them. And then there are structural reasons — there’s a shortage of mental health professionals, so that’s more structural.”

Last year’s report, Padilla-Frausto said, was a low estimate of the mental health needs in California because it was a survey of households. Many people with extreme mental health needs are homeless, or are incarcerated for crimes related to their illness.

Padilla-Frausto said this year’s study shows that the ACA could go a long way toward addressing a huge need for mental health services in California.

“It highlights the fact that there is an extensive amount of need for mental health services here,” she said, “and in terms of policy, it could inform future budget cuts. You want to make sure mental health services are offered, because mental health really impacts a lot of people’s ability to function. And if you cut those services, you’re hurting California as a whole.”

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