By Joel E. MillerA new, groundbreaking study shows that nearly 4 million people with mental illnesses who are uninsured reside in the 25 states that have refused to participate in the Medicaid Expansion program under the Affordable Care Act (ACA). Many of these individuals have severe mental health conditions and currently have no health insurance coverage through any public or private plan, but will be denied the opportunity to obtain coverage for treatment since those states have refused to participate. States declining Medicaid Expansion represent 55 percent of all uninsured people with major mental health disorders who are eligible for coverage in the new health insurance access initiative.