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Effect of Medicaid Expansions on Health Insurance Coverage and Access to Care among Low‐Income Adults with Behavioral Health Conditions
Author(s) -
Wen Hefei,
Druss Benjamin G.,
Cummings Janet R.
Publication year - 2015
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12411
Subject(s) - medicaid , waiver , poverty , medicine , environmental health , health insurance , gerontology , health care , mental health , demography , psychiatry , economics , sociology , political science , law , economic growth
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 < .05), a reduction in the probability of perceiving an unmet need for mental health ( MH ) treatment ( p < .05) and for SUD treatment ( p < .05), as well as an increase in the probability of receiving MH treatment ( p < .01). Conclusions The ongoing implementation of Medicaid expansions has the potential to improve health insurance coverage and access to care for low‐income adults with behavioral health conditions.