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Insurance Expansions and Children’s Use of Substance Use Disorder Treatment

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  • Sarah Hamersma
  • Johanna Catherine Maclean

Abstract

We provide the first evidence on the effects of expansions to private and public insurance programs on children’s use of specialty substance use disorder (SUD) treatment. We combine administrative government data over the period 1996 to 2017 with quasi-experimental differences-in-differences methods to study this question. Expansions of the private market – laws that compel insurers to cover SUD treatment services as parity with general healthcare – increase admissions by 21%. Increases in admissions are driven by patients with private coverage and receiving outpatient care. The number of admissions of patients with no insurance also increases following parity law adoption. There is mixed evidence on changes in admissions following a public insurance expansion that increases the income eligibility thresholds for Medicaid and the Children’s Health Insurance Program.

Suggested Citation

  • 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.
  • Handle: RePEc:nbr:nberwo:24499
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    References listed on IDEAS

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    1. Brendan Saloner & Yaa Akosa Antwi & Johanna Catherine Maclean & Benjamin Lê 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.
    2. Dhaval Dave & Swati Mukerjee, 2011. "Mental health parity legislation, cost‐sharing and substance‐abuse treatment admissions," Health Economics, John Wiley & Sons, Ltd., vol. 20(2), pages 161-183, February.
    3. Rosalie Liccardo Pacula & Jamie F. Chriqui & Joanna King, 2003. "Marijuana Decriminalization: What does it mean in the United States?," NBER Working Papers 9690, National Bureau of Economic Research, Inc.
    4. Christopher Carpenter, 2007. "Heavy Alcohol Use and Crime: Evidence from Underage Drunk-Driving Laws," Journal of Law and Economics, University of Chicago Press, vol. 50(3), pages 539-557.
    5. Brendan Saloner & Yaa Akosa Antwi & Johanna Catherine Maclean & Benjamin Cook, 2018. "Access to Health Insurance and Utilization of Substance Use Disorder Treatment: Evidence from the Affordable Care Act Dependent Coverage Provision," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 50-75, January.
    6. A. Colin Cameron & Jonah B. Gelbach & Douglas L. Miller, 2008. "Bootstrap-Based Improvements for Inference with Clustered Errors," The Review of Economics and Statistics, MIT Press, vol. 90(3), pages 414-427, August.
    7. Glied, Sherry & Zivin, Joshua Graff, 2002. "How do doctors behave when some (but not all) of their patients are in managed care?," Journal of Health Economics, Elsevier, vol. 21(2), pages 337-353, March.
    8. Johanna Catherine Maclean & Brendan Saloner, 2018. "Substance Use Treatment Provider Behavior and Healthcare Reform: Evidence from Massachusetts," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 76-101, January.
    9. James Bailey & Douglas Webber, 2017. "The political roots of health insurance benefit mandates," Journal of Economic Studies, Emerald Group Publishing Limited, vol. 44(2), pages 170-182, May.
    10. Rosalie L. Pacula & David Powell & Paul Heaton & Eric L. Sevigny, 2015. "Assessing the Effects of Medical Marijuana Laws on Marijuana Use: The Devil is in the Details," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 34(1), pages 7-31, January.
    11. Lo Sasso, Anthony T. & Buchmueller, Thomas C., 2004. "The effect of the state children's health insurance program on health insurance coverage," Journal of Health Economics, Elsevier, vol. 23(5), pages 1059-1082, September.
    12. David Card & Lara D. Shore-Sheppard, 2004. "Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions on Low-Income Children," The Review of Economics and Statistics, MIT Press, vol. 86(3), pages 752-766, August.
    13. Sabia, Joseph J. & Nguyen, Thanh Tam, 2016. "The Effect of Medical Marijuana Laws on Labor Market Outcomes," IZA Discussion Papers 9831, Institute of Labor Economics (IZA).
    14. Mingshan Lu & Thomas G. McGuire, 2002. "The Productivity of Outpatient Treatment for Substance Abuse," Journal of Human Resources, University of Wisconsin Press, vol. 37(2), pages 309-335.
    15. Corman, Hope & Grossman, Michael, 1985. "Determinants of neonatal mortality rates in the U.S. : A reduced form model," Journal of Health Economics, Elsevier, vol. 4(3), pages 213-236, September.
    16. 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.
    17. 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.
    18. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    19. Wen, Hefei & Hockenberry, Jason M. & Cummings, Janet R., 2017. "The effect of Medicaid expansion on crime reduction: Evidence from HIFA-waiver expansions," Journal of Public Economics, Elsevier, vol. 154(C), pages 67-94.
    20. James Bailey, 2013. "The Effect of Health Insurance Benefit Mandates on Premiums," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 40(1), pages 119-127, December.
    21. 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.
    22. Frank Sloan & Janet Mitchell & Jerry Cromwell, 1978. "Physician Participation in State Medicaid Programs," NBER Chapters, in: The Economics of Physician and Patient Behavior, pages 211-245, National Bureau of Economic Research, Inc.
    23. 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.
    24. 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.
    25. Anderson, D. Mark, 2010. "Does information matter? The effect of the Meth Project on meth use among youths," Journal of Health Economics, Elsevier, vol. 29(5), pages 732-742, September.
    26. Rosalie Liccardo Pacula & David Powell & Paul Heaton & Eric L. Sevigny, 2013. "Assessing the Effects of Medical Marijuana Laws on Marijuana and Alcohol Use: The Devil is in the Details," NBER Working Papers 19302, National Bureau of Economic Research, Inc.
    27. Akosa Antwi, Yaa & Moriya, Asako S. & Simon, Kosali I., 2015. "Access to health insurance and the use of inpatient medical care: Evidence from the Affordable Care Act young adult mandate," Journal of Health Economics, Elsevier, vol. 39(C), pages 171-187.
    28. Ettner, Susan L. & M. Harwood, Jessica & Thalmayer, Amber & Ong, Michael K. & Xu, Haiyong & Bresolin, Michael J. & Wells, Kenneth B. & Tseng, Chi-Hong & Azocar, Francisca, 2016. "The Mental Health Parity and Addiction Equity Act evaluation study: Impact on specialty behavioral health utilization and expenditures among “carve-out” enrollees," Journal of Health Economics, Elsevier, vol. 50(C), pages 131-143.
    29. 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).
    30. Johanna Catherine Maclean & Ioana Popovici & Elisheva R. Stern, 2018. "Health Insurance Expansions and Providers' Behavior: Evidence from Substance-Use- Disorder Treatment Providers," Journal of Law and Economics, University of Chicago Press, vol. 61(2), pages 279-310.
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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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