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OPINION

Expanding Medicaid would enable treatment for mental health illness and ease burden on law enforcement

By Brandon R. Davis and David Jordan
Brandon R. Davis
David Jordan

One of Kansas’ greatest needs is increased access to behavioral and mental health —especially in the criminal justice system.

County jails and state prisons have become the largest providers of mental health services in the state, and community police departments have become de facto behavioral health providers, even though the majority of them are not trained in this area. Using law enforcement professionals as mental health providers and jails as treatment facilities is extraordinarily costly to the state and local government. It’s also ineffective and unsustainable.

As members of the Governor’s Commission on Racial Equity and Justice, we were tasked with working to address systemic racism in Kansas. Gov. Kelly directed the Commission to focus our efforts first on law enforcement.

We took the charge seriously, and over the course of five months, the Commission held 11 bi-weekly meetings and 26 listening sessions with community members and stakeholders. They stressed the urgency of addressing behavioral health.

Data backs up what we heard during our sessions. People with behavioral health conditions, including serious mental illness and substance use disorders, are three to six times more likely to have contact with the criminal justice system. Many law enforcement encounters are the result of substance use or mental health issues.

Additionally, data shows racial disparities in the impacts of behavioral health systems on communities of color. For example, despite reporting a lower prevalence of substance use disorder than their white counter parts, Black and Brown communities experience greater problems associated with substance use, such as legal issues, justice system involvement, and social consequences.

To help address unmet behavioral health needs and prevent behavioral health calls and crises from occurring, the Commission strongly recommended that the state expand Medicaid to provide mental health and other health care coverage to populations currently not covered.

Expanding income eligibility for Medicaid will improve access to treatment for more than 30,000 Kansans who are uninsured and suffer from mental illness and substance use disorders. Instead of struggling to get care and having unnecessary contact with law enforcement, these citizens will have an opportunity to get treatment and to avoid interactions with the police and criminal justice system. In fact, those enrolled in Medicaid are 30% more likely to receive treatment. Connecting these individuals to behavioral health and other treatment services will help many of them to avoid returning to jail or prison.

It also saves money. Expanding Medicaid would reduce state general fund spending on law enforcement and behavioral health. We’ve seen this in other states — Idaho officials recently credited Medicaid expansion with a savings of more than $8 million in the past two years.

Idaho and the 38 other states that have expanded Medicaid and therefore enhanced access to treatment services have reduced health care costs, decreased arrests and realized savings in criminal justice costs of nearly $3 for every $1 invested in treatment. Kansas should be next.

Expanding Medicaid would help Kansans access services they need, reduce the burden on law enforcement and our criminal justice system, and improve the health and safety of our community. The time to expand Medicaid is now.

Brandon R. Davis is an assistant professor of law and society at the School of Public Affairs and Administration/African and African American Studies at The University of Kansas. David Jordan is the president of the United Methodist Health Ministry Fund.