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Thanks to the generosity of her church and family members, she receives some treatment for the depression and post-traumatic stress disorder she suffers as a result of the sexual assault she endured in 2012. But Troyer, 45, said her lack of health insurance and other uncovered medical costs, including a hospitalization and all her medications, has forced her into personal bankruptcy.
She lives in one of the 24 states that chose not to expand their Medicaid programs, offered under the Affordable Care Act. Those decisions have left about 3.7 million Americans with serious mental illness, psychological distress or a substance abuse disorder without health insurance, according to a recent report from the American Mental Health Counselors Association (AMHCA), a group that represents mental health professionals.