Cuts would increase burden for law enforcement
The health-care bill, which has already been passed by the U.S. House of Representatives and is pending in the U.S. Senate, includes proposals to impose caps on Medicaid or turn it into a block-grant program, resulting in cuts of billions of dollars.
The impact that cuts of this magnitude will have on Medicaid recipients who have disabilities or are elderly has been well documented. What hasn’t been discussed is the negative effect these cuts would have on our lawenforcement officers and correctional systems. Today, nearly 1 in 4 people in Ohio jails has a mental illness and this bill will likely make that number grow.
Each year, 10 million Americans and an estimated 500,000 Ohioans experience a serious mental illness. With the right treatment and support in place, people can get better and manage their conditions effectively. But without treatment, many become unstable and experience crises.
Frequently, law enforcement is called upon to respond. Talk to any police officer or sheriff and they will tell you that interacting with people with mental illness is a big part of their jobs. In fact, responding to mental-health crises is part of an officer’s daily work, often involving long drives to crisis centers and long waits in emergency rooms, diverting them from their other public-safety responsibilities.
People with serious mental illness are incarcerated at four times the rate of the general population. Once arrested, they stay in jail almost twice as long as others without mental illness who are facing similar charges. The costs of their incarceration are prohibitively high — two to three times greater than for people without mental illness.
In recent years, progress has been made in reducing these costly and time-consuming burdens for law enforcement and corrections. However, this progress will come to a grinding halt and the problems could grow worse if the Senate passes the health-care bill. Why? Because the bill contains massive cuts to Medicaid, the most important funder of services for people with serious mental illness.
Nearly one quarter of all people with serious mental illness in the United States are covered by Medicaid, and because the program is designed for people with disabilities, it covers people with the most serious conditions. In a letter to the House of Representatives earlier this year, Gov. John Kasich said that 500,000 Ohioans with mental-health needs and 25,000 Ohio veterans gained health-care coverage through the federally run health exchange or through Medicaid expansion.
Medicaid covers services that are vital to recovery for people with mental illness and addictions, including medications, case management and assistance with employment. Medicaid services are proven to help prevent recidivism and keep people out of jail. The healthcare bill, if it is enacted, will lead to significant cuts in federal funding for Medicaid for Ohio and other states.
Faced with federal cuts of this magnitude, the costs of care will be shifted to states and counties, many of whom have struggling economies. Inevitably, mental-health services will be cut to make up the shortfall. When cuts like these occur, burdens on law enforcement, corrections and other systems left to pick up the pieces of a broken mental health system become greater and greater.
In the long run, we all pay more in costly emergency rooms and in the compromise of our efforts to enhance public safety. Reforming America’s healthcare system to achieve greater efficiency is a laudable goal. But these reforms must be precise and thoughtful, guided by evidence of what works rather than by politics. The stakes for Ohio are simply too high. Let’s be careful not to make the jobs of law-enforcement officers even more difficult than they already are.