Almost 4 million people with severe mental illness will remain uninsured because 24 states have refused to expand Medicaid, according to a report from the American Mental Health Counselors Association (AMHCA).
Conversely, the states that are expanding Medicaid have helped about 3 million people with serious mental illness, psychological distress or a substance abuse disorder to obtain insurance.
"Health insurance is the passkey to good, timely healthcare services, and state policymakers in 25 states are locking people out of the system," AMHCA Executive Director Joel Miller said in a statement.
"It is really a tragedy," Miller told Stateline. "When uninsured people with mental health conditions, such as depression, gain Medicaid coverage, they become healthier and life expectancy increases, but in states that refuse to expand Medicaid, citizens will see their hopes dashed for a better life and better health."
Among the nonexpansion states, Indiana has the most mentally ill residents (62 percent) who would have been eligible for Medicaid, while Georgia has the fewest Medicaid-eligible adults with mental health conditions (27 percent), the report found.
What's more, several states are dramatically lowering their funding for community mental health programs. Between 2009 and 2012, mental health spending dropped by a total of $4.35 billion, the National Association of State Mental Health Program Directors estimated.
Those reductions have led some mental health advocates to push for states to expand Medicaid. "Medicaid expansion is the single most important thing our leadership could do for people with mental illness," Greg Hansch, policy coordinator of the National Alliance on Mental Illness in Texas, told Stateline.