The LePage administration has justified cutbacks to the state’s Medicaid program by describing those who’ve lost MaineCare coverage as “able-bodied people” who are shirking their duty to support themselves. But Gov. LePage’s definition of “able-bodied” doesn’t take into account how much many of these Mainers are held back by mental illness.

Particularly hard hit now, according to recent Maine Public Broadcasting Network coverage, are the 25,000 people who were removed from Maine-Care in January when the state tightened eligibility requirements.

MPBN’s report illustrates not only the impact that MaineCare cuts have had on vulnerable Maine residents, but also what these Mainers are willing to do in order to access mental health care – including trying to get into jail. So up front or further down the road, the state will still have to pay for services for those who need mental health treatment.

More than a third of adults on Maine-Care have a diagnosed mental health condition. But the young parents and childless adults who lost state-funded medical benefits this year also forfeited their ability to pay for mental health treatment. Lacking access to counseling or psychotropic prescription drugs, some turn to hospital emergency rooms, where the cost of care is far higher than in a doctor’s office.

Other people behave in a way that lands them in jail – sometimes deliberately, an advocate for Mainers with mental illness told MPBN. When a loved one is in crisis, some family members are being advised to “get them arrested because then they’ll have to get care,” said Jenna Mehnert, executive director of the National Alliance on Mental Illness’ Maine chapter.

But being in jail doesn’t ensure access to an effective psychotropic medication, according to Mehnert, since fewer prescription drugs are available in correctional facilities than through MaineCare. What’s more, the criminal justice system doesn’t have the staff or training to address mental health care needs, raising the risk for inmates with these issues that their conditions will get worse behind bars.

The reasoning behind the stricter MaineCare eligibility standards was that those affected would be eligible for coverage under the Affordable Care Act. Indeed, some of the people who lost their MaineCare may qualify for subsidized coverage under the ACA. Many others, however, either don’t earn enough to get subsidies or can’t afford the out-of-pocket costs that the ACA doesn’t pick up, like co-pays and deductibles.

Maine can’t cut its way to better mental health for its low-income residents. If the LePage administration won’t acknowledge this, then lawmakers should exercise their authority and ensure that the next budget allows needy Mainers to access the services they depend on.

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