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Access to help: The 'folks in the middle' often fall through the system's cracks

by Jaclyn Cosgrove Published: June 9, 2013

Traci Cook regularly talks to people who don't qualify to be treated at these centers. Often, they're uninsured working adults who make too much money to qualify for state-funded services.

“To meet the requirements for that mental health center, you've got to be incredibly poor,” said Cook, executive director of the National Alliance on Mental Illness Oklahoma.

It's difficult for this group to find a psychologist or psychiatrist. It's also a challenge to pay for medication.

“If you don't have insurance to cover it and you don't qualify for state aid, those are the folks who really struggle — the folks in the middle,” Cook said.

Under the Affordable Care Act, Oklahoma had the decision of whether to expand its Medicaid program, a state and federally funded insurance program for low-income children and adults.

This meant the program would change some of its requirements and that more people would qualify for Medicaid.

Gov. Mary Fallin announced in November that Oklahoma would not expand its program, citing the high costs that she felt the state would have to pay to implement the expansion.

“Such an expansion would be unaffordable, costing the state of Oklahoma up to $475 million between now and 2020, with escalating annual expenses in subsequent years,” Fallin said in a statement in November. “It would also further Oklahoma's reliance on federal money that may or may not be available in the future given the dire fiscal problems facing the federal government.”

Experts predict nearly 60,000 Oklahomans with mental illnesses would have qualified for Medicaid under the expansion.

These are the “folks in the middle” that Cook references.

“The cost of those people without insurance to our communities is way higher than giving them Medicaid and giving them access to treatment,” Cook said.