EDITORIAL: Mental health and Texas

Nov. 23--It's been a long time coming: On Nov. 8, the Obama administration issued a final ruling spelling out how health insurers will be required to provide comparable treatment for mental illness and addiction as for other health challenges.

In 2008, the George W. Bush administration mandated equal treatment from insurers who already covered mental health and addiction, but it went largely unenforced. Now, these clarified rules, coupled with the provisions of the new Affordable Care Act, will effectively level the playing field for those with insurance.

Statistics show that about one in four American adults suffers from a diagnosable mental disorder in any given year; 6 percent experience a serious mental illness, and one of every 10 children lives with a mental health condition. Yet fewer than a third of the adults and half of the children diagnosed receive mental health services.

Economically, the ruling will make for a more productive workforce, and should also ease the plight of the thousands of veterans with PTSD and traumatic brain injuries. It also completes the 23 executive actions the administration pledged to pursue to reduce gun violence after last December's school massacre in Connecticut.

So, this is an enormous leap forward for millions of Americans and should be applauded. But for those without insurance, the outlook is far grimmer, particularly in Texas, which has the largest number of uninsured in the nation, and ranks second to last in mental health funding.

When the Affordable Care Act was adopted in 2010, Medicaid was expanded to cover all Americans living below 138 percent of the poverty level, starting next January. But in 2012, the U.S. Supreme Court ruled that states could opt out of the expansion. Currently, 25 states are either opposed or uncertain. Of the 7 million or so adults left vulnerable in those states, the largest numbers -- about 20 percent -- are in Texas, where Gov. Rick Perry was one of the first, and loudest, to oppose ACA. "Texas will not be held hostage by the Obama administration's attempt to force us into this fool's errand of adding more than a million Texans to a broken system," he said.

This "fool's errand" is actually a great deal: In refusing federal Medicaid funds, Perry is forfeiting $7 billion that would provide insurance for those caught in the "coverage gap," about 1.3 million Texans, at a minuscule cost to the state. The federal government pays the full amount for the first three years, then gradually reduces its share to 90 percent starting in 2020.

So yes, improving mental health and addiction coverage is a wonderful step, but for our governor and the majority of the Legislature to callously exclude more than a million Texans from its benefits, along with other health coverage, defies all logic, not to mention decency. They should all be ashamed to place political expediency above their fellow Texans' health and security.

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