In the aftermath of the Newtown, CT school shooting, many Republicans on the talking head circuit pivoting away from calls for gun-related legislation. When pressed for solutions to the crisis of mass shootings, they cite the need to improve our system for providing mental health care to the people who need it.
I'm not against this, of course. We need to re-weave the safety net for people of all economic classes who suffer severe mental illness. However, the aforementioned Republicans are almost to a person not just against improving the mental health system in this country, but actively seek to defund it (to preserve tax cuts for the top 2%, the estate tax, to avoid a financial transaction tax, to avoid defense cuts, etc.).
This is pretty well-demonstrated in just two cites. First, from the National Health Policy Forum (PDF):
Medicaid is the largest payer of mental health services in the United States, contributing more than any other private or public source of funding. In 2003, Medicaid spent over $26 billion on mental health services — about 26 percent of total national mental health expenditures. This number has grown from approximately $7.5 billion (16.1 percent of total spending) in 1986, when Medicaid contributed less than three other payers: state and local governments, private health insurance, and consumers.So, those are the relevant policy facts. Here are the politics courtesy of the Washington Post:
The increase in Medicaid spending is primarily the result of the shift in service delivery
from public institutions, where (as described later) Medicaid funding is limited, to community-based services, for which Medicaid covers a larger share of the costs and provides greater access. Other factors contributing to the increase in Medicaid costs include eligibility expansions, increased use of services, and state cost shifting.
Over the next 10 years, the Ryan plan would cut Medicaid by $642 billion by repealing the Affordable Care Act and by $750 billion through new caps on federal spending—a 34 percent cut to Medicaid spending over the next decade, according to Edwin Park of the Center and Budget and Policy Priorities.These Republicans claiming they're interested in improving the mental health care system are lying. They want to massively cut the largest payer, and the payer who focuses most intensely on those that would otherwise get no treatment. These cuts will result in reduced eligibility for the program, and reduced funds for those eligible. That's the mental health policy Republicans are actually for. And it's an immediately pressing one heading into the "fiscal cliff" and "deficit ceiling" negotiations.
Who would that impact? First, by overturning the ACA, the Ryan plan would prevent 11 million people from gaining Medicaid coverage by 2022, according to the Congressional Budget Office’s latest estimates.
That’s why the CBO believes that $750 billion in Medicaid cuts under the Ryan plan would “probably require states to reduce payments to providers, curtail eligibility for Medicaid, provide less extensive coverage to beneficiaries, or pay more themselves than would be the case under current law.”