CMS Data Shows Vulnerable Americans Forgoing Mental Health Care During COVID-19 Pandemic

Health is both mental and physical health, and until we recognize this as a community, we will struggle to address the health of our community, according to TMC Healthcare.

The U.S. Department of Health and Human Services estimates that one in five Americans over age 18 will experience a mental health problem in a regular year. The stigma revolving around mental health is significant and, unfortunately, negative attitudes and beliefs toward people who have a mental health condition are common and are a hinderance to getting the care that is needed. Along with stigma, the pandemic has been a huge roadblock to accessing mental health care.

CMS has released data that highlights the continued impact the COVID-19 pandemic is having on Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries and utilization of health services.  The data show that, from March through October 2020, beneficiaries have foregone millions of primary, preventive, and mental health care visits due to the pandemic compared to the same time period in 2019. Although utilization rates for some treatments have rebounded to pre-pandemic levels, mental health services show the slowest rebound.

The data saw a 34% decline in the number of mental health services utilized by children under age 19, compared to the same time period in 2019, and 22% decline in the number of mental health services utilized by adults aged 19 to 64, compared to the same time period in 2019.

• This decline in utilization is occurring at a time when preliminary evidence shows mental health conditions have worsened nationwide.

The gap in service utilization due to the pandemic, particularly for mental health services, may have a substantial impact on long-term health outcomes. Medicaid and CHIP-funded mental health services – in addition to primary and preventative services – cover the majority of children, people living in poverty, and those with special health care needs. Medicaid and CHIP also cover millions of racial and ethnic minorities.

CMS Acting Administrator Liz Richter said,

This new data provides a window into the impacts of the pandemic for marginalized communities – particularly children and other vulnerable people – and is critical as we work towards meeting the needs of those that rely on Medicaid and CHIP.

The solution: 

To help close this gap in services, CMS is emphasizing mental health care in its recently launched Connecting Kids to Coverage National Campaign, a national outreach and enrollment initiative funded under the Children’s Health Insurance Program Reauthorization Act and the Affordable Care Act, that reaches out to families with children and teens eligible for Medicaid and CHIP.

President Biden’s American Rescue Plan provided funding to address mental health and substance use challenges, including $3 billion in funding for block grants to tackle mental health and substance use prevention, treatment, and recovery services. This is alongside $1.4 billion to support the mental health needs of health care professionals and first responders, as well as funding specifically for pediatric mental health.

According to CMS, it will continue monitoring and working with states, providers and stakeholders to develop and implement innovative ways to provide access to critical health care such as preventative childhood vaccinations and mental health services to beneficiaries enrolled in Medicaid and CHIP.