Health Insurance and Mental Health Treatment Use Among Adults With Criminal Legal Involvement After Medicaid Expansion

被引:3
|
作者
Howell, Benjamin A. [1 ,2 ]
Hawks, Laura C. [4 ,5 ]
Balasuriya, Lilanthi [3 ]
Chang, Virginia W. [6 ,7 ]
Wang, Emily A. [2 ]
Winkelman, Tyler N. A. [8 ,9 ]
机构
[1] Yale Sch Med, SEICHE Ctr Hlth & Justice, New Haven, CT 06510 USA
[2] Yale Sch Med, Sect Gen Internal Med, New Haven, CT 06510 USA
[3] Yale Sch Med, Natl Clinician Scholars Program, New Haven, CT USA
[4] Med Coll Wisconsin, Div Gen Internal Med, Milwaukee, WI USA
[5] Med Coll Wisconsin, Ctr Adv Populat Sci, Milwaukee, WI USA
[6] New York Univ, Dept Social & Behav Sci, Sch Global Publ Hlth, New York, NY USA
[7] New York Univ, Dept Populat Hlth, Grossman Sch Med, New York, NY USA
[8] Hennepin Healthcare Res Inst, Hlth Homelessness & Criminal Justice Lab, Minneapolis, MN USA
[9] Hennepin Healthcare, Div Gen Internal Med, Dept Med, Minneapolis, MN USA
关键词
USE DISORDER TREATMENT; SUBSTANCE USE DISORDERS; AFFORDABLE CARE ACT; OPIOID USE DISORDER; BEHAVIORAL HEALTH; COVERAGE; PRISONERS; ACCESS; REFORM;
D O I
10.1176/appi.ps.20220171
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective: Individuals with criminal legal involvement have high rates of substance use and other mental disorders. Before implementation of the Affordable Care Act's Medicaid expansion, they also had low health insurance coverage. The objective of this study was to assess the impact of Medicaid expansion on health insurance coverage and use of treatment for substance use or other mental disorders in this population. Methods: The authors used restricted data (2010-2017) from the National Survey on Drug Use and Health (NSDUH). Using a difference-in-differences approach, the authors estimated the impact of Medicaid expansion on health insurance coverage and treatment for substance use or other mental disorders among individuals with recent criminal legal involvement. Results: The sample consisted of 9,910 NSDUH respondents who were ages 18-64 years, had a household income <= 138% of the federal poverty level, and reported past-year criminal legal involvement. Medicaid expansion was associated with an 18 percentage-point increase in insurance coverage but no change in receipt of substance use treatment among individuals with substance use disorder. Individuals with any other mental illness had a 16 percentage-point increase in insurance coverage but no change in receipt of mental health treatment. Conclusions: Despite a large increase in health insurance coverage among individuals with criminal legal involvement and substance use or other mental disorders, Medicaid expansion was not associated with a significant change in treatment use for these conditions. Insurance access alone appears to be insufficient to increase treatment for substance use or other mental disorders in this population.
引用
收藏
页码:1019 / 1026
页数:8
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