State Variations in Medicaid Enrollment and Utilization of Substance Use Services: Results from a National Longitudinal Study

Overview

Journal J Subst Abuse Treat

Specialty Psychiatry

Date 2018 May 1

PMID 29706176

Citations 5

Authors

Ramin Mojtabai

Kenneth A Feder

Marc Kealhofer

Noa Krawczyk

Carla Storr

Kayla N Tormohlen

Andrea S Young

Mark Olfson

Rosa M Crum

Affiliations

Soon will be listed here.

Abstract

Medicaid enrollment varies considerably among states. This study examined the association of Medicaid enrollment with the use of substance health services in the longitudinal National Epidemiologic Survey on Alcohol and Related Conditions of 2001-2005. Instrumental variable methods were used to assess endogeneity of individual-level Medicaid enrollment using state-level data as instruments. Compared to the uninsured, Medicaid covered adults were more likely to use substance use disorder treatment services over the next three years. States that have opted to expand Medicaid enrollment under the Affordable Care Act will likely experience further increases in the use of these service over the coming years.

Citing Articles

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Medicaid Expansion and Low-Income Adults with Substance Use Disorders.

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References

Wen H, Hockenberry J, Borders T, Druss B . Impact of Medicaid Expansion on Medicaid-covered Utilization of Buprenorphine for Opioid Use Disorder Treatment. Med Care. 2017; 55(4):336-341. DOI: 10.1097/MLR.0000000000000703. View

Ali M, Teich J, Mutter R . Reasons for Not Seeking Substance Use Disorder Treatment: Variations by Health Insurance Coverage. J Behav Health Serv Res. 2016; 44(1):63-74. DOI: 10.1007/s11414-016-9538-3. View

CALLAHAN J, Shepard D, Beinecke R, Larson M, Cavanaugh D . Mental health/substance abuse treatment in managed care: the Massachusetts Medicaid experience. Health Aff (Millwood). 1995; 14(3):173-84. DOI: 10.1377/hlthaff.14.3.173. View

Mark T, Yee T, Levit K, Camacho-Cook J, Cutler E, Carroll C . Insurance Financing Increased For Mental Health Conditions But Not For Substance Use Disorders, 1986-2014. Health Aff (Millwood). 2016; 35(6):958-65. DOI: 10.1377/hlthaff.2016.0002. View

Deck D, Vander Ley K . Medicaid eligibility and access to mental health services among adolescents in substance abuse treatment. Psychiatr Serv. 2006; 57(2):263-5. DOI: 10.1176/appi.ps.57.2.263. View

Rabinowitz J, Bromet E, Lavelle J, Hornak K, Rosen B . Changes in insurance coverage and extent of care during the two years after first hospitalization for a psychotic disorder. Psychiatr Serv. 2001; 52(1):87-91. DOI: 10.1176/appi.ps.52.1.87. View

Becker W, Fiellin D, Merrill J, Schulman B, Finkelstein R, Olsen Y . Opioid use disorder in the United States: insurance status and treatment access. Drug Alcohol Depend. 2008; 94(1-3):207-13. DOI: 10.1016/j.drugalcdep.2007.11.018. View

Deck D, Wiitala W, Laws K . Medicaid coverage and access to publicly funded opiate treatment. J Behav Health Serv Res. 2006; 33(3):324-34. DOI: 10.1007/s11414-006-9018-2. View

Ali M, Teich J, Mutter R . The role of perceived need and health insurance in substance use treatment: implications for the Affordable Care Act. J Subst Abuse Treat. 2015; 54:14-20. DOI: 10.1016/j.jsat.2015.02.002. View

10.

Tsai J, Pilver C, Hoff R . Potential mental health needs of US adult residents under different provisions of the Affordable Care Act. J Clin Psychiatry. 2014; 75(12):1402-10. DOI: 10.4088/JCP.13m08885. View

11.

Chen L, Crum R, Martins S, Kaufmann C, Strain E, Mojtabai R . Service use and barriers to mental health care among adults with major depression and comorbid substance dependence. Psychiatr Serv. 2013; 64(9):863-70. PMC: 4049190. DOI: 10.1176/appi.ps.201200289. View

12.

Bhattacharya J, Goldman D, Sood N . The link between public and private insurance and HIV-related mortality. J Health Econ. 2003; 22(6):1105-22. DOI: 10.1016/j.jhealeco.2003.07.001. View

13.

Grant B, Stinson F, Dawson D, Chou S, Dufour M, Compton W . Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 2004; 61(8):807-16. DOI: 10.1001/archpsyc.61.8.807. View

14.

Mark T, Levit K, Vandivort-Warren R, Buck J, Coffey R . Changes In US spending on Mental Health And Substance Abuse Treatment, 1986-2005, and implications for policy. Health Aff (Millwood). 2011; 30(2):284-92. DOI: 10.1377/hlthaff.2010.0765. View

15.

Grant B, Goldstein R, Chou S, Huang B, Stinson F, Dawson D . Sociodemographic and psychopathologic predictors of first incidence of DSM-IV substance use, mood and anxiety disorders: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Mol Psychiatry. 2008; 14(11):1051-66. PMC: 2766434. DOI: 10.1038/mp.2008.41. View

16.

Wen H, Druss B, Cummings J . Effect of Medicaid Expansions on Health Insurance Coverage and Access to Care among Low-Income Adults with Behavioral Health Conditions. Health Serv Res. 2015; 50(6):1787-809. PMC: 4693853. DOI: 10.1111/1475-6773.12411. View

17.

Glasner-Edwards S, Rawson R . Evidence-based practices in addiction treatment: review and recommendations for public policy. Health Policy. 2010; 97(2-3):93-104. PMC: 2951979. DOI: 10.1016/j.healthpol.2010.05.013. View

18.

Holahan J, Coughlin T, Ku L, Lipson D, Rajan S . Insuring the poor through Section 1115 Medicaid waivers. Health Aff (Millwood). 1995; 14(1):199-216. DOI: 10.1377/hlthaff.14.1.199. View

19.

Deck D, McFarland B . Medicaid managed care and substance abuse treatment. Psychiatr Serv. 2002; 53(7):802. DOI: 10.1176/appi.ps.53.7.802. View

20.

Aletraris L, Edmond M, Roman P . Insurance Receipt and Readiness for Opportunities under the Affordable Care Act: A National Survey of Treatment Providers for Substance Use Disorders. J Psychoactive Drugs. 2017; 49(2):141-150. DOI: 10.1080/02791072.2017.1306661. View