Handguns are displayed in the Remington booth during the 2013 NRA Annual Meeting and Exhibits on May 5, 2013 in Houston, Texas.
Photo by Justin Sullivan/Getty

Focusing on guns and mental health means talking about the ACA

Updated
In the wake of every mass-shooting – events that occur with heartbreaking regularity in the United States, but no other industrialized democracy – political rhetoric tends to follow a predictable trajectory. Democratic officials, in general, raise the prospect of new policies to curtail gun violence.
 
And Republican officials, in general, decry such efforts as anti-freedom, preferring to focus on practically anything else. For some on the right, mass shootings serve as an excuse to renew conversations about violent entertainment (though plenty of other countries enjoy similar cultural fare without violent consequences). For others, gun massacres are reason to start merging religion and public schools (as if the Second Amendment is inviolate, but the First Amendment is malleable).
 
But in recent months, a focus on mental health – which must have tested well with focus groups – has become one of the GOP’s principal talking points. Senate Majority Whip John Cornyn (R-Texas), the day of the mass-shooting in Oregon last week, urged President Obama to back Cornyn’s bill “to address mental health factor in mass violence incidents.”
 
In the Washington Post over the weekend, University of Chicago professor Harold Pollack described some provisions of Cornyn’s proposal as “helpful and constructive,” but highlighted a missing piece of the puzzle.
Cornyn’s proposal does not address the most glaring issue in American mental health policy: the Affordable Care Act’s Medicaid expansion. Medicaid expansion was always the public health cornerstone of ACA. It remains the single most important measure to expand access to mental health and addiction treatment, serving severely vulnerable populations such as the homeless, addressing the complicated medical and psychiatric difficulties of many young men cycling through our jails and prisons.
I suspect that for many Republicans, the idea of “Obamacare” playing a meaningful role in preventing mass-shootings must sound ridiculous. After all, “Obamacare” is inherently bad, even when it’s good, and all of its provisions must be rejected because, well, just because.
 
But Pollack is entirely correct, and if GOP officials are going to ignore gun-safety measures to focus on mental health, they should probably grow up and reconcile their mental-health rhetoric with their mindless, knee-jerk hostility towards Medicaid expansion through the ACA.
 
Indeed, Pollack’s Washington Post piece added:
In 2013, the National Alliance on Mental Illness (NAMI) released a report endorsing Medicaid expansion. The report argued that “States that decline to expand Medicaid will miss as good an opportunity as they may ever have to address this shameful void in access to mental health treatment.” Addressing the connection between mental illness and violence, NAMI concluded:
 
“In the aftermath of Newtown, many politicians and policy makers have promised to take steps to fix America’s broken mental health system. Expanding Medicaid in all states would represent a significant step towards keeping those promises.”
My suspicion, based on years of conservative apoplexy about expanding Americans’ access to affordable health security, is that when Republicans talk about mental health as a substitute for a debate about gun policy, they’re creating a smoke screen. Many of these partisans aren’t serious about expanding mental-health services, so much as they’re pushing a talking point to circumvent an even less pleasant conversation about the frequency of gun deaths in the United States.
 
They can, however, prove these suspicions wrong fairly easily. Pollack concluded, “If any other politician suggests that mental health rather than gun policy is central to reducing mass homicides, ask where they stand on Medicaid expansion. Their answer will be clarifying.”
 
Let’s start with Senator Cornyn, who fought tooth and nail to block Medicaid expansion in Texas, despite the fact that Texas has the highest uninsured rate in the entire country. Any chance he’ll consider a new, more constructive posture on the issue as part of his renewed interest on the issue of mental health?
 
 

Affordable Care Act, John Cornyn, Medicaid and Obamacare

Focusing on guns and mental health means talking about the ACA

Updated