Benefits to mental health, addiction services discussed

Back in 2013, Gov. John Kasich, expanded Medicaid in the state for people with incomes of up to 138 percent of the federal poverty line, allowing more than 700,000 low-income Ohioans access to health care, the vast majority of whom were previously uninsured.

On Monday afternoon, state and local officials met with community members and service providers at the Ironton branch of the Briggs Lawrence County Library to discuss the impact the state’s expansion of Medicaid has had on the Tri-State region.

“When you look at our community and the Tri-State, we see many issues; chronic care, addiction, oral health, obesity,” D.R. Gossett, executive director of the Ironton-Lawrence County Community Action Organization (CAO) Medical Centers, said. “People struggle with those areas, and Medicaid expansion has allowed us and others to be able to provide services that otherwise wouldn’t exist in the community.”

On hand from the state were Ohio Department of Medicaid Director Barbara Sears and Ohio Department of Mental Health and Addiction Services Director Tracy Plouk.

“The purpose of this is to highlight some of the successes people have made in health care with the Medicaid expansion in Ohio,” Plouk said. “Without access to health care, it can be difficult to maintain employment or take care of children. And the expansion in Ohio has been critically important for people struggling with mental illness and addiction.”

The Medicaid expansion was the result of House Bill 64, and those impacted are referred to as Group VIII, which are Ohioans age 19-64 with income at or below 138 percent of the federal poverty line. An assessment on Group VIII was conducted and found that Medicaid expansion in Ohio has been beneficial to Group VIII enrollees in terms of access to physical and mental health care, health care utilization and reduced emergency department use, detection of unknown or unaddressed prior health conditions (particularly chronic health conditions), security of and opportunities for employment, the lessening of family financial stress, declines in medical debt-holding and an increase in the ability to pay other nonmedical bills.

As far as helping with mental health and addiction specifically, the assessment found that Group VIII enrollees with mental illness are making progress in obtaining needed mental health care.

Nearly half of the Group VIII enrollees (44 percent) who met mental health screening criteria reported that access to mental health treatment had become easier, compared to 5 percent who indicated that access had become harder and 43 percent who indicated that it was the same.

Group VIII enrollees were found to be less likely than pre-expansion enrollees to receive prescriptions for medications associated with abuse and dependence, such as opioids and benzodiazepines. Those with substance abuse disorders were more likely to report improvement in overall access to care (72.1 percent versus 60.9 percent), access to prescription medication (74.4 percent versus 61.2 percent) and access to mental health care (44.7 percent versus 27.7 percent) than enrollees without substance use disorders. The improvement in access to care since enrollment in Medicaid is consistent with research indicating improved access to treatment for opioid and other substance use disorders because of changes in state and federal health policies.

In the past, there were limited options for low-income enrollees with behavioral health and/or substance abuse to have health care coverage for treatment. However, with the expansion, those with mental health or addiction are able to get treatment for their chronic diseases.

“There are certainly some challenges as they get the state government together and their budgets. That’s a priority and they wanted to talk to us about the Medicaid expansion policies and how it impacts our communities,” Gossett said. “The importance of the Medicaid expansion itself relates to providing services to individuals who are otherwise struggling to get the health care they need. Community Action is about trying to help provide opportunities for those in need, and if you don’t have the right kind of health care as a baseline, everything else is an uphill battle.”

Gossett said he was very appreciative of the state for coming and talking about progress the Medicaid expansion has shown.

“We’ve seen the leadership in Columbus for a number of years now, but recently, really be engaged and listening and trying to use an evidence based approach to solve tough problems,” Gossett said. “We appreciate the opportunity to contribute and appreciate their efforts.”

Due to the personal nature of some of the topics discussed, the actual roundtable discussion was not open to the media.

For more information on the Group VIII assessment, visit http://medicaid.ohio.gov/Portals/0/Resources/Reports/Annual/Group-VIII-Assessment.pdf.