LET MEDICAID HELP FIGHT DRUG ABUSE

The governor's unhealthy aversion to Medicaid threatens to undermine
lawmakers' efforts to put new money into community drug-treatment and
mental-health programs.

GOV. Jim Gilmore will be doing Virginia a grave disservice if, as
expected, he vetoes expansion of the state's Medicaid program, a key
part of the General Assembly's legislative package to improve
mental-health and substance-abuse services.

A particular bright spot in the biennial budget that legislators
recently passed is the use, for the first time, of Medicaid to pay for
community-based substance-abuse treatment programs.

That and expansion of Medicaid eligibility to cover more people in
need of community-based mental-health services would pump much-needed
money into programs critical to overhauling Virginia's scandalously
antiquated system of delivering care.

Republican Gilmore has identified the federal Medicaid program as
"welfare," however, and is on record opposing its expansion for fear
of creating unwelcome new entitlements.

Virginians with diseases of the brain are entitled, though, to
top-quality mental-health treatment in the least-restrictive
environment possible. Virginians whose communities are wracked by the
social dysfunction that accompanies drug addiction are entitled to
respond in the most effective way they can to protect the safety of
their families and the health of their neighborhoods.

Community-based treatment frequently is the best response, but
unavailable because the state does not provide enough dollars to meet
the needs.

The administration is not hostile to substance-abuse treatment. SABRE,
its ill-conceived Substance Abuse Reduction Effort, contains one
sensible component: $15 million for drug and alcohol treatment for
prison inmates.

But addicts should not have to land in prison before they can get
help.

If all are agreed that successful treatment is far preferable to
ever-harsher punishment for substance abuse, the issue becomes one of
how to provide the desirable alternative.

State Sen. William Wampler, a fellow Republican, does not share
Gilmore's fear and loathing of Medicaid. "I don't think anybody says
it's not a cost-effective way to provide services to a needy
population." Independent consultants concluded last year that to
expand substance-abuse treatment, using Medicaid would be less
expensive than not.

Gilmore's ideological resistance has blinded him to good policy and
good sense.

If the mist does not lift, and the governor vetoes the Medicaid
expansion, lawmakers should rally to override the veto. Such political
defiance would be rare, indeed, but an act demanded by the public need.