Access To Mental Health Care Increased But Not For Substance Use, While Disparities Remain

Abstract

We assessed whether early implementation of Affordable Care Act (ACA) Medicaid expansion and state health insurance exchanges increased access to mental health and substance use treatment among those in need and whether these changes differed by racial/ethnic group. We found that mental health treatment rates increased significantly but found no evidence of a reduction in the wide racial/ethnic disparities in mental health treatment that preceded ACA expansion from 2005 to 2013.

Health Insurance Trends and Access to Behavioral Healthcare Among Justice-Involved Individuals—United States, 2008–2014

“…Our finding that Medicaid is associated with higher treatment rates for some behavioral health conditions compared to private insurance builds upon previous work indicating that Medicaid improves access to behavioral health care for lowincome adults. 29,30 Our findings suggest that Medicaid expansion may be of greater benefit for this population than private insurance expansion, perhaps because Medicaid offers improved care coordination to connect individuals to services 31,32 or because Medicaid providers are more familiar with SUDs, which are more prevalent among low-income populations. 33 We note, however, that we were unable to determine when individuals accessed treatment services relative to their justice involvement.…”

What has economics got to do with it? The impact of socioeconomic factors on mental health and the case for collective action

“…Current debate, focused on insurance access and eligibility, is troublingly void of a focus on prevention or addressing social determinants and structural racism. In fact, while mental health care access improved following implementation of the Affordable Care Act, there was no progress in reducing racial and ethnic disparities (Creedon and Le Cook, 2016). While advocates and researchers are pulled toward policy and legislative fights over healthcare provision, larger macro issues impacting health and mental health, i.e.…”

Commercial Health Plan Coverage of Selected Treatments for Opioid Use Disorders from 2003 to 2014

“…However, it should be noted that these expansions do not necessarily translate to increased numbers of people who seek or receive SUD treatment. (Ali, Teich & Mutter 2015; Busch et al 2014; Creedon & Cook 2016; Saloner et al 2016; Thalmayer et al 2016). Other barriers such as stigma, variation in treatment availability, and the unique degree to which SUD treatment is paid for by sources other than private health insurance were not immediately addressed by MHPAEA and the ACA (Ali, Teich & Mutter 2015; Mark et al 2016).…”