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May 6, 2016

Mental Health Coverage Gap Remains Despite Lawmakers’ Efforts, Assertions

State lawmakers haven’t gone as far as they should, or as far as some claimed, in the effort to help more people with serious mental illness get the help they need.

Starting in July, an estimated 3,600 additional Virginians who struggle economically and suffer from serious mental illness will be able to get some treatment through the Governor’s Access Program (GAP). By devoting an additional $5.4 million with an equal federal match, lawmakers increased the eligibility level in this program for a single person to approximately $10,000, up from roughly $7,700.

The legislature’s stated commitment to treatment for mental illness was captured well in this quote from Speaker Howell’s communications director: “The House of Delegates has worked closely with Governor McAuliffe on the Governor’s Access Program, which provides mental health services to those making less than 100% of the federal poverty level. Instead of expanding Medicaid, the House has made this plan a priority.”

The trouble is the new, higher eligibility level that the General Assembly actually enacted in the law only goes up to 80 percent of the federal poverty line, not 100 percent. By only expanding coverage for mental health services to 80 percent of the federal poverty line lawmakers continue to leave people out in the cold. And by refusing to expand Medicaid, state lawmakers rejected a common-sense move that would have provided comprehensive medical coverage, including mental health treatment, for many more low-income uninsured Virginians and saved the state money.

Had lawmakers actually made the Governor’s Access Program a priority, they would have ensured that all low-income people suffering from serious mental illness could get the medications they need. Fully raising eligibility to 100 percent of the poverty line would have also meant that the new threshold would be closer to $12,000 per year, matching the minimum income needed to qualify for tax credits to purchase comprehensive coverage in the Marketplace. Instead, there continues to be a situation where even people who barely manage to make ends meet can make “too much” money to qualify for the Governor’s Access Plan and too little to qualify for Marketplace coverage. So they’re still stuck in the gap.

No one suffering from a serious mental illness should be denied the care they need. Without the appropriate medications, there are men and women, fathers and mothers, sons and daughters who are left to struggle without a realistic shot at managing their disease.

Health Care

Massey Whorley

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