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Losing Insurance and Behavioral Health Hospitalizations: Evidence from a Large-Scale Medicaid Disenrollment

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  • Maclean, J. Catherine

    (Temple University)

  • Tello-Trillo, Sebastian

    (University of Virginia)

  • Webber, Douglas A.

    (Federal Reserve Board of Governors)

Abstract

We study the effects of losing insurance on behavioral health – mental health and substance use disorder (SUD) – community hospitalizations. We leverage variation in public insurance eligibility offered by a large-scale Medicaid disenrollment. Losing insurance decreased SUD-related hospitalizations but mental illness hospitalizations were unchanged. Use of Medicaid to pay for behavioral health hospitalizations declined post-disenrollment. Mental illness hospitalization financing shifted to private insurance, Medicare, and patients, while SUD treatment financing shifted entirely to patients. We investigate implications of reliance on data that is not representative at the level of the treatment variable and propose a possible solution.

Suggested Citation

  • 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).
    • Handle: RePEc:iza:izadps:dp12463
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    Cited by:

    1. Viviano, Davide & Bradic, Jelena, 2023. "Synthetic Learner: Model-free inference on treatments over time," Journal of Econometrics, Elsevier, vol. 234(2), pages 691-713.
    2. Lindsey Rose Bullinger & Sebastian Tello-Trillo, 2021. "Connecting Medicaid and child support: evidence from the TennCare disenrollment," Review of Economics of the Household, Springer, vol. 19(3), pages 785-812, September.
    3. Michael F. Pesko & Charles J. Courtemanche & Johanna Catherine Maclean, 2019. "The Effects of Traditional Cigarette and E-Cigarette Taxes on Adult Tobacco Product Use," NBER Working Papers 26017, National Bureau of Economic Research, Inc.
    4. Nikpay, Sayeh, 2022. "The medicaid windfall: Medicaid expansions and the target efficiency of hospital safety-net subsidies," Journal of Public Economics, Elsevier, vol. 208(C).
    5. Barış K. Yörük & Yiran Han, 2024. "Age-based health insurance coverage policies and mental health," Journal of Population Economics, Springer;European Society for Population Economics, vol. 37(2), pages 1-26, June.

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    More about this item

    Keywords

    healthcare; community hospitalizations; insurance; mental illness; substance use disorders; data quality;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • 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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