Opponents of Medicaid Expansion Adopt Reganesque View of the Mentally Ill

Monday, December 17, 2012

by Shanelle Matthews

Sasha Matthews watches as her 4-year-old son Gavin sleeps soundly in his bed. The soft, paisley printed blankets hugging his small frame – his left foot hanging loosely off the edge. She watches his chest rise and fall and wonders when, if ever, Gavin will look her in the eye and say, “I love you.” Gavin is one of many children born with autism, a spectrum disorder that affects a person’s ability to communicate and interact with others.  Like many other parents of children on the spectrum, Sasha is optimistic that through rigorous therapy and treatment, Gavin will lead a healthy and happy life – free of the stigma that often plagues the mentally underdeveloped. However, she doesn’t have many people advocating for her, especially not the Governor of the state where she and Gavin call home.

Louisiana Governor Bobby Jindal is one of several Republican governors who have vowed to reject the federal plan to expand Medicaid under President Obama’s Affordable Care Act. The national health laws Medicaid expansion says that the federal government will pay the full cost of the expansion through 2016. After that, the states will only pick up 5 percent of the cost through 2019, and 10 percent of the cost thereafter helping to cover an estimated 7 million more Americans. States would benefit tremendously from this federally supported subsidy and millions more Americans would have access to healthcare.

Louisiana is facing is a nearly 860 million dollar budget cut to its Medicaid program as a result of a change in the state’s Medicaid funding formula to correct what has been characterized as an error in the funding that allowed the state to draw down more federal money than it should have. The state of Medicaid coverage in Louisiana is already dismal. Most states base Medicaid eligibility for parents on household income and how it compares to the federal poverty level, which was $18,530 for a family of three in 2011. In Louisiana, the eligibility cutoff for a working parent is 25 percent of federal poverty or $4,633 for a family of three. Effectively if you make more than $5,000 a year, you do not qualify for Medicaid.

Due to these cuts, Southeast Louisiana Hospital (SELH), home to over 200 mental health patients, will soon begin the closure process.  Officials of the Louisiana Department of Health and Hospitals have been vague about how they will provide services for the psychiatric patients (including adolescent and adult patients with Autism). Without insurance, Medicare or Medicaid these patients will be displaced. This places a burden on the poorest and most impacted people in the state, a burden that policy makers are familiarly dismissive of.

During his post WWII tenure as Governor of California, Ronald Regan began closing all state funded mental facilities and cutting aid to federally funded community mental health programs (in an effort to realign the economy). This left the country in a haze of confusion as those with little to no mental capacity were discharged with nowhere to go. Patients were left homeless. Families were burdened with relatives they could not care for overall confirming the fast growing notion that those with the least mattered least.

52% of all the money Louisiana spends on Medicaid services is allocated to people with disabilities. Similar to Regan’s economic realignment policies, the state budget cuts will leave the mentally ill in a precarious limbo.  The cuts, coupled with the rejection of the Medicaid expansion bill, will leave hundreds of thousands of psychiatric patients and their families guessing about their access to quality healthcare, including Sasha and Gavin.

Accessing quality resources to help Gavin hurdle the barriers of autism is a constant struggle for Sasha. Yet, knowing they live in a state that refuses to prioritize the needs of people with disabilities leaves her gravely concerned for his future. If hospitals like Southeast Louisiana, that have serviced patients with disabilities for over 60 years, fall victim to unfair budgets cuts, where will people like Sasha and Gavin go for help?

Shanelle Matthews is a blogger, new and online media professional and the Communications Manager at Forward Together. Follow her on Twitter @freedom_writer