The Main Mental Health Issue in This Country Is in the Republican Party

And please do not forget this most salient fact of all: There has been one major expansion of mental health spending and coverage in recent American history. It was called the Affordable Care Act. The ACA’s impact on the country’s mental health has been salutary, according to this Commonwealth Fund report. The change has been particularly striking in states that accepted the new Medicaid funding.

I know I need hardly remind you, but again, for the record: Only one Republican in the House or Senate voted for it—Representative Anh “Joseph” Cao, who served for one term in a bluish Louisiana district (actually, he voted for it in November 2009 when the House passed its version, but by the time of the final passage vote the next March, Cao voted no). The GOP then spent years trying to repeal and “replace” it. Trump also wanted it repealed. So the sole major expansion of mental health coverage in this century was contained in a bill whose passage every Republican in Washington opposed and on which most Republican governors have refused to participate in the state-level implementation. Come to think of it, probably the sole reason the red state of Montana ranks in the top 10 on mental health spending is that the state took the Medicaid expansion money under former Democratic Governor Steve Bullock.

Republicans are not going to expand mental health funding. Mental health care is for sissies and liberals. The only thing they’re going to expand is access to guns. We know this because recent history tells us so. Last week in Vox, Zack Beauchamp posted a shocking but not surprising report on academic studies of legislative responses at the state level to mass shootings. The finding? The norm in this country has been that mass shootings have been used by state legislatures and governors as an excuse to loosen gun laws, not tighten them. This is our country.