Across the South, state leaders are rejecting Medicaid expansion as part of their overall disdain for the Affordable Care Act.

Tight budgets and skepticism of federal programs transcend state lines.

South Carolina is not alone. Georgia, Mississippi, Louisiana and Alabama are some of the more than a dozen states that have opted not to expand Medicaid coverage. In doing so, they have turned their backs on some of the country’s poorest people.

Most folks don’t want to depend on the government. But some people do need a helping hand on the way to self-reliance, and that’s where the program expansion comes in.

Medicaid-funded health treatment programs report long-term cost savings and strong success rates.

By cutting off aid to those at or near the poverty line, particularly children and families, state government does a greater disservice than it does by providing public assistance. And it almost guarantees higher health care costs later on.

That’s especially true in the case of mental health treatment.

Numbers show need

Mental health care is health care. The Post and Courier series, “Lost Among Us,” has shown that mental illness affects nearly 25 percent of the U.S. population.

A May report from the National Alliance on Mental Illness says that 60 percent of Americans who have serious mental illness have no mental health care. Medicaid pays for half of all publicly funded mental health services in the U.S., but that leaves up to 2.7 million Americans without treatment.

There are 78,691 people in Alabama, 72,038 in South Carolina, 59,320 in Louisiana, and 42,312 people in Mississippi who could receive mental health treatment if Medicaid expanded. But it seems those folks will go untreated, at least for now.

Pay now or pay later

In May, the Center for Medicaid and Children’s Health Insurance Program Services and the Substance Abuse and Mental Health Services Administration shared some additional information about how treatment benefits children and young adults with mental illness.

Students who received care for mental illness through Medicaid-administered programs showed better attendance at school, had decreased symptoms and more stable living situations, and less contact with law enforcement.

Keeping children and young adults out of psychiatric residential treatment facilities yields a cost savings of 75 percent, the programs said.

So by expanding services offered through Medicaid now, which the federal government will fund for the first three years, states should eventually save money. When federal funding erodes, the programs can be cut.

Folks here and across the South often are skeptical of the federal government — sometimes with good reason. But it’s hard to argue with the benefits of keeping people with mental illness out of jails and emergency rooms. Just like it’s hard to argue with the benefits of treating health problems early.

The long-term goal is the same: to produce functional members of society who can work, stay well and care for their families.

And eventually, with less governmental help.