The Council of Economic Advisers released a report, Missed Opportunities: The Consequences of State Decisions Not to Expand Medicaid, which looks at how Medicaid expansion in the States affects access to care, mental health, general health, financial security and state economies. The Affordable Care Act has expanded health coverage by providing financial support to States that choose to expand Medicaid eligibility to non-elderly individuals in families with incomes below 133 percent of the Federal Poverty Level. Since 26 States and the District of Columbia chose to accept federal funding, 5.2 million people have gained coverage through Medicaid or the Children’s Health Insurance Program. If the 24 States that have not yet expanded Medicaid continue not to do so, the Urban Institute estimates that 5.7 million people will be deprived of health insurance coverage in 2016.
According to the report, “if the 24 States that have not yet expanded Medicaid did so, there would be 458,000 fewer people experiencing depression” and “States that have already expanded Medicaid will reduce the number of people experiencing depression by 348,000.” These numbers are based on information from the Oregon Health Insurance Experiment, which found that Medicaid coverage reduced the likelihood that an individual screened positive for depression on a standardized eight-question questionnaire by 9.2 percentage points. The experiment also showed improvement in mental health as self-reported through a three question battery on the effect of mental health on quality of life. If the 24 States who have not expanded Medicaid eligibility continue on that trajectory, then hundreds of thousands of people will continue to not have access to mental health care that could help them.