OP-ED: Obamacare, coupled with Medicaid expansion, has transformed access to behavioral health care for Illinois residents with mental illness and addiction disorders. Since the inception of the Affordable Care Act, almost 66,000 Illinois residents have accessed care that they otherwise would not have obtained.

Today, however, tens of thousands risk losing behavioral health care in Illinois. A survey by the Illinois Association for Behavioral Health of its members estimated that 26,490 Illinois citizens would lose behavioral health services if the Medicaid expansion component is rescinded under proposed Trumpcare. Financially, in fiscal year 2019, the president’s health plan would cut Illinois’ share of Medicaid funding by $1.4 billion.

Overall, according to the non-partisan Congressional Budget Office, the Trumpcare plan would cut coverage for 975,700 Medicaid beneficiaries; cause 301,600 Illinoisans to lose employer-sponsored health insurance; cut 62,000 from the Illinois insurance exchange; and cut coverage for 55,000 elderly residents, totaling more than 1.3 million Illinoisans who would lose health insurance under the federal legislation currently under consideration.

Moreover, roughly 2,038,000 individuals in Illinois, who have pre-existing health conditions, are at risk of having their coverage rescinded, being denied coverage, or being charged significantly more for coverage if the Congress approves the proposed American Health Care Act.

The loss of addiction treatment and mental health care services would cut not only care to 26,490, but also it would inflame the heroin and opioid epidemic that is convulsing the state.

In Illinois, heroin-related overdose deaths increased 22 percent from 2013 to 2014 and the opioid-related death rate rose 120 percent from 2014 from 2015. In 2016, Illinois Criminal Justice Information Authority researchers surveyed police chiefs and sheriffs for its Illinois Drug Threat Assessment and more than half of respondents identified heroin as the greatest drug threat in the state.

For example, in 2015, Will County registered 53 overdose deaths linked to heroin and fentanyl, which is more than the 51 deaths caused by traffic accidents. In Cook County, there were 526 heroin and fentanyl deaths in 2015 compared to 240 traffic deaths.

Critically, in the current opioid epidemic fight, Medicaid pays for 15.4% of addiction treatment medication in Illinois.

Additionally, Governor Bruce Rauner’s signature criminal justice reform goal to reduce the Illinois prison system by 25% would be jeopardized with the loss of federal money from the rollback of Medicaid expansion.

Without Medicaid expansion, Illinois will need to spend tens of millions of its general revenue fund dollars—an estimated $84.5 million—to pay for critical community-based behavioral healthcare services in support of the Commission on Criminal Justice and Sentencing Reform’s goal to reduce the state’s prison population 25% by 2025. That’s money that Illinois does not have.

The health legislation being considered currently by Congress would unleash a health care crisis, in general, and a behavioral health care crisis, in particular, in Illinois on a staggering financial and human scale if approved by federal lawmakers.

Illinois’ congressional delegation – which has a healthy interest in its constituents’ behavioral health well-being and their own – has a clear choice.

sara@ilabh.org