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Public Insurance and Psychotropic Prescription Medications for Mental Illness

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  • Johanna Catherine Maclean
  • Benjamin L. Cook
  • Nicholas Carson
  • Michael F. Pesko

Abstract

Mental illnesses are prevalent in the United States and globally. Cost is a critical barrier to treatment receipt. We study the effects of recent and major eligibility expansions within 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 to 2017. Our findings suggest that these expansions increased psychotropic prescriptions by 22.3%. We show that Medicaid, and not patients, financed these prescriptions. For states expanding Medicaid, the total cost of these prescriptions was $30.8M. 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 evidence that Medicaid expansion reduced a proxy for serious mental illness: suicide.

Suggested Citation

  • 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.
  • Handle: RePEc:nbr:nberwo:23760
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    Cited by:

    1. 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).
    2. Borgschulte, Mark & Vogler, Jacob, 2020. "Did the ACA Medicaid expansion save lives?," Journal of Health Economics, Elsevier, vol. 72(C).
    3. 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.
    4. Jacob Vogler, 2020. "Access to Healthcare and Criminal Behavior: Evidence from the ACA Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 39(4), pages 1166-1213, September.

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    More about this item

    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

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