Effect of Medicaid Expansions on Health Insurance Coverage and Access to Care among Low-Income Adults with Behavioral Health Conditions

• Published in: Health services research 2015-12, Vol.50 (6), p.1787-1809
• Main Authors: Wen, Hefei, Druss, Benjamin G., Cummings, Janet R.
• Format: Article
• Language: English
• Subjects: access/demand/utilization of services; Adult; Adults; Age Factors; Behavioral health care; Behavioral medicine; Behavioural medicine; Best of 2015 AcademyHealth Annual Research Meeting; Best of the 2015 AcademyHealth Annual Research Meeting; Conditions; Coverage; Cross-Sectional Studies; Data acquisition; Data collection; Drug abuse; Drug development; Eligibility Determination; Extraction; Female; Government programs; Health behavior; Health care; Health care access; Health insurance; Health Services Accessibility - statistics & numerical data; Health Services Research; Humans; Income; Individual differences; Insurance; Insurance coverage; Insurance Coverage - statistics & numerical data; Insurance, Health; Low income groups; Male; Medicaid; Medicaid - legislation & jurisprudence; Medicaid - statistics & numerical data; Medically Uninsured - statistics & numerical data; Mental disorders; Mental Disorders - therapy; Mental health; Mental health care; Mental health services; Middle Aged; Patient Protection and Affordable Care Act - legislation & jurisprudence; Personal income; Poverty; Psychological distress; Reduction; Sampling methods; Service provision; Sex Factors; Socioeconomic Factors; Studies; Substance abuse; Substance abuse treatment; Substance use; Substance use disorder; Surveys; United States
• ISSN: 0017-9124; 1475-6773
• DOI: 10.1111/1475-6773.12411

Objective To examine the effect of Medicaid expansions on health insurance coverage and access to care among low‐income adults with behavioral health conditions. Data Sources/Study Setting Nine years (2004–2012) of individual‐level cross‐sectional data from a restricted‐access version of National Survey on Drug Use and Health. Study Design A quasi‐experimental difference‐in‐differences design comparing outcomes among residents in 14 states that implemented Medicaid expansions for low‐income adults under the Section §1115 waiver with those residing in the rest of the country. Data Collection/Extraction Methods The analytic sample includes low‐income adult respondents with household incomes below 200 percent of the federal poverty level who have a behavioral health condition: approximately 28,400 low‐income adults have past‐year serious psychological distress and 24,900 low‐income adults have a past‐year substance use disorder (SUD). Principal Findings Among low‐income adults with behavioral health conditions, Medicaid expansions were associated with a reduction in the rate of uninsurance (p