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Originally published March 18, 2013 at 4:37 PM | Page modified March 18, 2013 at 4:37 PM

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Op-ed: Expand Medicaid under the Affordable Care Act to improve mental-health care

Expanding Medicaid access under the Affordable Care Act will help homeless people struggling with mental illness, according to guest columnists Bill Hobson and Paul Tipps.

Special to The Times

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OUR mental-health system has gaping holes and we cannot continue to ignore them. In our work at Downtown Emergency Service Center we see these holes reflected every day in the people who fall through them. Our mission is to provide the kind of care that helps people get back on their feet and find stability. Expanding Medicaid access to 250,000 people in our state under the Affordable Care Act will help us fill those holes and make that care possible.

Recent and past cuts to mental-health programs have left us scrambling to provide care, causing our neighbors with mental illnesses to end up in emergency rooms and jails for costlier treatment while politicians in Olympia debate how to care for many of the people we see.

We recently met a woman living with severe mental illness. About once a week she would call 911 for transportation to the emergency room, where doctors and nurses would treat her most urgent need, whether it was a stomachache or withdrawal symptoms from her addiction. The ER then released her back to the street.

Those weekly ambulance rides cost taxpayers around $1,500, not including the emergency-room bills, when what she needed was long-term, comprehensive treatment for mental illness and addiction. She cycled in an out of short-term care, and her addiction worsened as she tried to self-medicate to alleviate the symptoms of her mental illness. Our mental-health system let her down, and across the board, we weren’t able to provide the care she needed.

These kinds of stories are all too common.

We pay a high price for people falling through the cracks of the system, the result of cuts that were designed to save our state money but have had the opposite effect. Many patients forgo the mental-health care they need or families face health crises that end in significant debt or bankruptcy. Others end up seeking care in emergency rooms, creating a strain on our hospitals to care for an influx of patients who have nowhere else to go. These are costly settings to provide care and our emergency rooms and jails aren’t equipped to provide the ongoing care and crisis intervention that would help our neighbors get back on their feet.

The immense cost to provide care in these ineffective settings is passed on to all of us. The average family pays more than $1,000 a year to cover the increasing costs of our uninsured neighbors.

This is a crisis we must address. The solution is to provide the kind of health care that fully addresses people’s needs, whether mental health or basic medical care. Our community has better, more cost-effective solutions and it’s time we made choices that make sense for our budgets and our well-being.

We have the choice to expand health care in our state to 250,000 more people, which would help treat those with mental illnesses and the uninsured who currently can’t afford care. The decision rests with our state Legislature, and it shouldn’t involve partisan politics.

The Affordable Care Act, known as Obamacare, provides federal money to expand Medicaid coverage to treat more patients, allowing many people for the first time to receive mental-health services, vaccines, cancer screenings and management of chronic conditions such as diabetes and high blood pressure. This is an incredible deal. It could save our state $225 million in the next two years and create nearly 10,000 jobs.

The people we see every day can’t afford for us to not improve their care. Taxpayers can’t continue to fund the broken system.

It’s time for us to get serious about fixing a community crisis and start providing the care our neighbors deserve. Medicaid expansion is the right choice for our state.

Bill Hobson, left, is the executive director of Downtown Emergency Service Center. Paul Tipps is a residential counselor at the center and a member of SEIU Healthcare 1199NW.

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