IDEAS home Printed from https://ideas.repec.org/a/bpj/bejeap/v19y2019i1p25n7.html
   My bibliography  Save this article

Public Health Insurance and Prescription Medications for Mental Illness

Author

Listed:
  • Maclean Johanna Catherine

    (Economics, Temple University, Philadelphia, PV, USA)

  • Cook Benjamin
  • Carson Nicholas

    (Harvard Medical School, Boston, MA, USA)

  • Pesko Michael F

    (Georgia State University Andrew Young School of Policy Studies, Atlanta, United States of America)

Abstract

Mental illnesses are prevalent in the United States and globally. Cost is a critical barrier to treatment receipt. We study the effects of the Affordable Care Act's recent expansion of Medicaid, a public insurance system for the poor in the U.S., on psychotropic prescription medications for mental illness. We estimate differences-in-differences models using administrative data on medications for which Medicaid was a third-party payer over the period 2011–2017. Our findings suggest that these expansions increased psychotropic prescriptions by 21.0%. We show that Medicaid, and not patients, financed these prescriptions. For states expanding Medicaid, the total cost of these prescriptions was $28.0 M by the second quarter of 2017. Expansion effects were experienced across most major mental illness categories and across states with different levels of patient need, system capacity, and expansion scope. We find no statistically significant evidence that Medicaid expansion reduced mental illness.

Suggested Citation

  • Maclean Johanna Catherine & Cook Benjamin & Carson Nicholas & Pesko Michael F, 2019. "Public Health Insurance and Prescription Medications for Mental Illness," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 19(1), pages 1-25, January.
  • Handle: RePEc:bpj:bejeap:v:19:y:2019:i:1:p:25:n:7
    DOI: 10.1515/bejeap-2018-0067
    as

    Download full text from publisher

    File URL: https://doi.org/10.1515/bejeap-2018-0067
    Download Restriction: For access to full text, subscription to the journal or payment for the individual article is required.

    File URL: https://libkey.io/10.1515/bejeap-2018-0067?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Joshua D. Angrist & Jörn-Steffen Pischke, 2009. "Mostly Harmless Econometrics: An Empiricist's Companion," Economics Books, Princeton University Press, edition 1, number 8769.
    2. Kosali Simon & Aparna Soni & John Cawley, 2017. "The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(2), pages 390-417, March.
    3. David H. Autor, 2003. "Outsourcing at Will: The Contribution of Unjust Dismissal Doctrine to the Growth of Employment Outsourcing," Journal of Labor Economics, University of Chicago Press, vol. 21(1), pages 1-42, January.
    4. Tamer Abdelgawad & Lisa Egbuonu-Davis, 2006. "Preferred Drug Lists and Medicaid Prescriptions," PharmacoEconomics, Springer, vol. 24(3), pages 55-63, December.
    5. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, Oxford University Press, vol. 111(2), pages 391-430.
    6. Hamersma, Sarah & Kim, Matthew, 2013. "Participation and crowd out: Assessing the effects of parental Medicaid expansions," Journal of Health Economics, Elsevier, vol. 32(1), pages 160-171.
    7. Michael F. Lovenheim, 2009. "The Effect of Teachers' Unions on Education Production: Evidence from Union Election Certifications in Three Midwestern States," Journal of Labor Economics, University of Chicago Press, vol. 27(4), pages 525-587, October.
    8. Frean, Molly & Gruber, Jonathan & Sommers, Benjamin D., 2017. "Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act," Journal of Health Economics, Elsevier, vol. 53(C), pages 72-86.
    9. Luojia Hu & Robert Kaestner & Bhashkar Mazumder & Sarah Miller & Ashley Wong, 2016. "The Effect of the Patient Protection and Affordable Care Act Medicaid Expansions on Financial Wellbeing," NBER Working Papers 22170, National Bureau of Economic Research, Inc.
    10. Michael R. Richards & Joachim Marti & Johanna Catherine Maclean & Jason Fletcher & Donald Kenkel, 2017. "Tobacco Control, Medicaid Coverage, and the Demand for Smoking Cessation Drugs," American Journal of Health Economics, University of Chicago Press, vol. 3(4), pages 528-549, Fall.
    11. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    12. Lucas Goodman, 2017. "The Effect of the Affordable Care Act Medicaid Expansion on Migration," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(1), pages 211-238, January.
    13. Justin Wolfers, 2006. "Did Unilateral Divorce Laws Raise Divorce Rates? A Reconciliation and New Results," American Economic Review, American Economic Association, vol. 96(5), pages 1802-1820, December.
    14. W. David Bradford & William D. Lastrapes, 2014. "A Prescription For Unemployment? Recessions And The Demand For Mental Health Drugs," Health Economics, John Wiley & Sons, Ltd., vol. 23(11), pages 1301-1325, November.
    15. Manning, Willard G. & Mullahy, John, 2001. "Estimating log models: to transform or not to transform?," Journal of Health Economics, Elsevier, vol. 20(4), pages 461-494, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Benjamin W. Cowan & Zhuang Hao, 2020. "Medicaid Expansion and the Mental Health of College Students," NBER Working Papers 27306, National Bureau of Economic Research, Inc.
    2. Benjamin W. Cowan & Zhuang Hao, 2021. "Medicaid expansion and the mental health of college students," Health Economics, John Wiley & Sons, Ltd., vol. 30(6), pages 1306-1327, June.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Johanna Catherine Maclean & Benjamin L. Cook & Nicholas Carson & Michael F. Pesko, 2017. "Public Insurance and Psychotropic Prescription Medications for Mental Illness," NBER Working Papers 23760, National Bureau of Economic Research, Inc.
    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. Johanna Catherine Maclean & Michael F. Pesko & Steven C. Hill, 2017. "The Effect of Insurance Expansions on Smoking Cessation Medication Prescriptions: Evidence from ACA Medicaid Expansions," NBER Working Papers 23450, National Bureau of Economic Research, Inc.
    4. Lee, Jun Yeong & Winters, John V., 2020. "State Medicaid Expansion and the Self-Employed," IZA Discussion Papers 12997, Institute of Labor Economics (IZA).
    5. Popovici, Ioana & Maclean, J. Catherine & French, Michael, 2017. "The Effects of Health Insurance Parity Laws for Substance Use Disorder Treatment on Traffic Fatalities: Evidence of Unintended Benefits," IZA Discussion Papers 10746, Institute of Labor Economics (IZA).
    6. 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.
    7. Maclean, J. Catherine & Tello-Trillo, Sebastian & Webber, Douglas A., 2019. "Losing Insurance and Behavioral Health Hospitalizations: Evidence from a Large-Scale Medicaid Disenrollment," IZA Discussion Papers 12463, Institute of Labor Economics (IZA).
    8. Sarah Miller & Norman Johnson & Laura R Wherry, 2021. "Medicaid and Mortality: New Evidence From Linked Survey and Administrative Data," The Quarterly Journal of Economics, Oxford University Press, vol. 136(3), pages 1783-1829.
    9. Jean M. Abraham & Anne B. Royalty & Coleman Drake, 2019. "The impact of Medicaid expansion on employer provision of health insurance," International Journal of Health Economics and Management, Springer, vol. 19(3), pages 317-340, December.
    10. Cortnie Shupe, 2021. "Public Health Insurance and Medical Spending: Evidence from the ACA Medicaid Expansion," CESifo Working Paper Series 8827, CESifo.
    11. Jonathan Gruber & Johanna Catherine Maclean & Bill Wright & Eric Wilkinson & Kevin G. Volpp, 2020. "The effect of increased cost‐sharing on low‐value service use," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1180-1201, October.
    12. Freedman, Seth & Lin, Haizhen & Simon, Kosali, 2015. "Public health insurance expansions and hospital technology adoption," Journal of Public Economics, Elsevier, vol. 121(C), pages 117-131.
    13. Kaufmann, Cornel & Schmid, Christian & Boes, Stefan, 2017. "Health insurance subsidies and deductible choice: Evidence from regional variation in subsidy schemes," Journal of Health Economics, Elsevier, vol. 55(C), pages 262-273.
    14. Aparna Soni, 2020. "The effects of public health insurance on health behaviors: Evidence from the fifth year of Medicaid expansion," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1586-1605, December.
    15. Johanna Catherine Maclean & Sebastian Tello-Trillo & Douglas Webber, 2019. "Losing insurance and behavioral health inpatient care: Evidence from a large-scale Medicaid disenrollment," NBER Working Papers 25936, National Bureau of Economic Research, Inc.
    16. Ghosh, Ausmita & Simon, Kosali & Sommers, Benjamin D., 2019. "The Effect of Health Insurance on Prescription Drug Use Among Low-Income Adults:Evidence from Recent Medicaid Expansions," Journal of Health Economics, Elsevier, vol. 63(C), pages 64-80.
    17. Joanna Woronkowicz & Aparna Soni & Seth Freedman & Kosali Simon, 2020. "How have recent health insurance expansions affected coverage among artist occupations in the USA?," Journal of Cultural Economics, Springer;The Association for Cultural Economics International, vol. 44(1), pages 117-154, March.
    18. Dunn, Abe & Knepper, Matthew & Dauda, Seidu, 2021. "Insurance expansions and hospital utilization: Relabeling and reabling?," Journal of Health Economics, Elsevier, vol. 78(C).
    19. Vincent Vandenberghe, 2019. "Alternatives to polynomial trend-corrected differences-in-differences models," Applied Economics Letters, Taylor & Francis Journals, vol. 26(5), pages 358-361, March.
    20. Hamersma, Sarah & Maclean, Johanna Catherine, 2021. "Do expansions in adolescent access to public insurance affect the decisions of substance use disorder treatment providers?," Journal of Health Economics, Elsevier, vol. 76(C).

    More about this item

    Keywords

    mental illness; prescription medications; healthcare; insurance;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bpj:bejeap:v:19:y:2019:i:1:p:25:n:7. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: https://www.degruyter.com .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Peter Golla (email available below). General contact details of provider: https://www.degruyter.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.