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. 2016 Jun 1;35(6):1017-21.
doi: 10.1377/hlthaff.2016.0098.

Access To Mental Health Care Increased But Not For Substance Use, While Disparities Remain

Timothy B Creedon  1 , Benjamin Lê Cook  2
Affiliations

Access To Mental Health Care Increased But Not For Substance Use, While Disparities Remain

Timothy B Creedon et al. Health Aff (Millwood). .

Abstract

We assessed whether early implementation of Affordable Care Act (ACA) Medicaid expansion and state health insurance exchanges increased access to mental health and substance use treatment among those in need and whether these changes differed by racial/ethnic group. We found that mental health treatment rates increased significantly but found no evidence of a reduction in the wide racial/ethnic disparities in mental health treatment that preceded ACA expansion from 2005 to 2013.

Keywords: Disparities; Health Reform; Insurance Coverage < Insurance; Mental Health/Substance Abuse.

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Figures

EXHIBIT 1
EXHIBIT 1. Any past-year mental health treatment among people with past-year serious psychological distress
SOURCE Authors’ analysis of data from the National Survey on Drug Use and Health, 2005–14. NOTES Predicted probabilities generated from difference-in-differences regression model adjusting for age, sex, marital status, and self-reported health status. Unweighted n = 54, 575. aSignificantly different from 2005–07 (p < 0.05). bSignificantly different from 2008–10 (p < 0.05). cSignificantly different from 2011–13 (p < 0.05).
EXHIBIT 2
EXHIBIT 2. Any past-year specialty substance use disorder treatment among people with past-year substance use disorders
SOURCE Authors’ analysis of data from the National Survey on Drug Use and Health, 2005–14. NOTES Predicted probabilities generated from difference-in-differences regression model adjusting for age, sex, marital status, and self-reported health status. Unweighted n = 52, 258. aEstimate of rate for Asians in 2005–07 omitted because of insufficient cell size.
EXHIBIT 3
EXHIBIT 3. Prevalence of cost and insurance problems as reasons for unmet mental health treatment need, 2014
SOURCE Authors’ analysis of data from the National Survey on Drug Use and Health, 2014. NOTES Predicted probabilities generated from difference-in-differences regression model adjusting for age, sex, marital status, and self-reported health status. Unweighted n = 25, 080. aSignificantly different from non-Hispanic whites (p < 0.05).
EXHIBIT 4
EXHIBIT 4. Any health insurance coverage among people meeting criteria for substance use disorders or serious psychological distress
SOURCE Authors’ analysis of data from the National Survey on Drug Use and Health, 2005–14. NOTES Predicted probabilities generated from difference-in-differences regression model adjusting for age, sex, marital status, and self-reported health status. Unweighted n = 91, 186. aSignificantly different from 2005–07 (p < 0.05). bSignificantly different from 2008–10 (p < 0.05). cSignificantly different from 2011–13 (p < 0.05).
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References

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