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Access to health insurance and utilization of public sector substance use treatment: Evidence from the Affordable Care Act dependent coverage provision

Author

Listed:
  • Brendan Saloner

    (Department of Health Policy and Management, Johns Hopkins University)

  • Yaa Akosa Antwi

    (Department of Economics, Indiana University - Purdue University Indianapolis)

  • Johanna Catherine Maclean

    (Department of Economics, Temple University)

  • Benjamin LeÌ‚ Cook

    (Center for Multicultural Mental Health Research, Harvard Medical School)

Abstract

The relationship between insurance coverage and use of substance use disorders (SUDs) treatment is not well understood. SUD treatment has long been segregated from general medical care, and has had low reliance on private insurance. We examine changes in admissions to publicly-funded, specialty SUD treatment following the implementation of a 2010 Affordable Care Act provision requiring health insurers to offer dependent coverage to young adult children. We compare admissions from the 2007-2012 Treatment Episode Data Set among targeted young adults to older adults. We find that admissions to treatment declined by 11 percent among young adults after the provision. However, the share of young adults covered by private insurance increased by 9.3 percentage points and the share with private insurance as the payment source increased by 6.5 percentage points. This increase was largely offset by decreased self-payment and payment by state and local government sources, followed by decreased Medicaid payment. Public sector providers gained new revenues from private insurers, and the share of patients paying primarily out-of-pocket decreased. Our findings suggest expansions of private insurance may not increase demand for public sector treatment but could provide important revenue for existing patients.

Suggested Citation

  • Brendan Saloner & Yaa Akosa Antwi & Johanna Catherine Maclean & Benjamin LeÌ‚ Cook, 2015. "Access to health insurance and utilization of public sector substance use treatment: Evidence from the Affordable Care Act dependent coverage provision," DETU Working Papers 1509, Department of Economics, Temple University.
    • Handle: RePEc:tem:wpaper:1509
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    File URL: http://www.cla.temple.edu/RePEc/documents/DETU_15_09.pdf
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    References listed on IDEAS

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    Cited by:

    1. Johanna Catherine Maclean & Ioana Popovici & Elisheva Stern, 2015. "Health Insurance Expansions and Provider Behavior: Evidence from Substance Use Disorder Providers," DETU Working Papers 1510, Department of Economics, Temple University.
    2. Johanna Catherine Maclean & Brendan Saloner, 2019. "The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(2), pages 366-393, March.
    3. Sarah Hamersma & Johanna Catherine Maclean, 2018. "Insurance Expansions and Children’s Use of Substance Use Disorder Treatment," NBER Working Papers 24499, National Bureau of Economic Research, Inc.
    4. Ioana Popovici & Johanna Catherine Maclean & Michael T. French, 2017. "Health Insurance and Traffic Fatalities: The Effects of Substance Use Disorder Parity Laws," NBER Working Papers 23388, National Bureau of Economic Research, Inc.

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    More about this item

    Keywords

    Dependent care coverage; Affordable Care Act; health insurance; substance use disorder treatment;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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