September is a time in which government and nonprofit advocates hold up many health awareness issues, ranging from childhood obesity awareness to healthy aging. Recently, September was named “North Carolina National Recovery Month.” Unfortunately, this latter action appears to be mostly symbolic rather than substantive.
While a signed proclamation by Gov. Pat McCrory is a nice gesture and maybe even a step in the right direction to address such a complicated health issue, it does not go anywhere near far enough. That’s because neither the Governor nor his allies in the General Assembly support the obvious policy change that would actually would do more than anything else to guarantee access to treatment for substance use disorders (SUD): Medicaid expansion.
Earlier this year, US Department of Health and Human Services released a report which found that Medicaid expansion positively impacts low-income individuals’ ability to access and utilize behavioral health, which includes SUD treatment.
In North Carolina, there are 144,000 adults that reported having mental illness or SUD that lacked health coverage who could have received necessary treatment if lawmakers had only closed the coverage gap. It is estimated that only 13 percent of adults in the coverage gap receive treatment for SUD or mental illness.
Not surprisingly, there is voluminous literature highlighting the negative social, physical, and financial outcomes when individuals with mental illness and/ or SUD cannot receive the care they need. We know that many people with SUD have co-existing physical health conditions, which may lead to a shorter life expectancy. When people cannot receive the ongoing care they need to treat SUD, it is harder for them to obtain and keep a job. Research confirms that SUD treatment helped employers save over $8,000 per worker, per year as a result of increased work productivity and a reduction in the number of days missed from work. Compensated treatment helps reduce the economic and emotional strain on family members too.
And, of course, closing the coverage by expanding Medicaid access leads to numerous systemic benefits as well, including promoting the financial viability of hospitals and health systems by reducing emergency department visits and even bolstering state criminal justice systems by reducing recidivism and incarceration rates. There is also research showing that Medicaid expansion along with other social supports can help to address the many unmet mental health and SUD needs of individuals experiencing homelessness. So not only does closing the coverage gap address individual treatment for SUD, but it broadly and positively impacts our neighborhoods and cities.
It’s great that the Governor has issued a proclamation, but we must ask ourselves and our lawmakers: What kind of North Carolina do we want to live in? A state that only supports its residents on paper or one that takes real action to provide meaningful access to health care to everyone so that we all — individuals, businesses and communities as a whole — can thrive? Clearly, North Carolina needs actual deeds to from state leaders to bring about such a reality.