Accomplishments And Challenges In Medicaid Mental Health

Rowland, Diane; Garfield, Rachel; Elias, Risa

doi:10.1377/hlthaff.22.5.73

Cited by 11 publications

(9 citation statements)

References 9 publications

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“…Policy makers face several implementation decisions regarding the Medicaid expansion, and it is unclear whether it will be structured and implemented with the special needs of this population in mind. For example, Medicaid has developed a unique scope of services to meet the needs of low-income individuals with severe mental illness, including intensive case management, crisis intervention, and wraparound psychosocial services (37). Under PPACA, a similar scope of services may not be available to the newly eligible Medicaid population, since states are only required to provide new Medicaid enroUees coverage on par with private insurance benefits rather than full traditional Medicaid benefits (38).…”

Section: Discussionmentioning

confidence: 99%

The Impact of National Health Care Reform on Adults With Severe Mental Disorders

Garfield¹,

Zuvekas²,

Lave³

et al. 2011

AJP

177

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Section: Discussionmentioning

confidence: 99%

The Impact of National Health Care Reform on Adults With Severe Mental Disorders

Garfield¹,

Zuvekas²,

Lave³

et al. 2011

AJP

177

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“…Indeed, young children of mothers with mental illness are less likely than those of mothers without mental illness to have public (vs. no) health insurance despite the fact that child eligibility is quite generous under the SCHIP program [25], suggesting that administrative hassles play a role. For example, the process of applying for Social Security Disability benefits can be onerous, as the applicant is expected to provide a considerable amount of documentation and program personnel may be reluctant to qualify individuals on the basis of mental disorders (the fact that only 4% of Medicaid beneficiaries receive coverage because a mental disorder qualifies them as disabled [31] provides some evidence that this may be the case).…”

Section: Discussionmentioning

confidence: 99%

Mental Illness as a Risk Factor for Uninsurance Among Mothers of Infants

Noonan

Carroll

Reichman

et al. 2008

Matern Child Health J

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The objective of this study was to assess the extent to which maternal prenatal mental illness is associated with mothers' health insurance status 12-18 months after giving birth. The sample consisted of 2,956 urban, mostly unwed, mothers who gave birth in 20 large U.S. cities between 1998 and 2000 and participated in the Fragile Families and Child Wellbeing birth cohort study. Multinomial logistic regression models were used to assess associations between maternal prenatal mental illness and whether the mother had private, public, or no insurance one year after the birth. Covariates included the mother's and child's physical health status, the father's physical and mental health status, and numerous other maternal, paternal, and family characteristics. Potential mediating factors were explored. The results showed that mothers with prenatal diagnosed mental illness were almost half as likely as those without mental illness diagnoses to have private insurance (vs. no insurance) one year after the birth. Among mothers who did not have a subsequent pregnancy, those with prenatal mental illness were less likely than those without mental illness diagnoses to have public insurance than to be uninsured. Screening positive for depression or anxiety at one year decreased the likelihood that the mother had either type of insurance. Policies to improve private mental health care coverage and public mental health services among mothers with young children may yield both private and social benefits. Encounters with the health care and social service systems experienced by pregnant and postpartum women present opportunities for connecting mothers to needed mental health services and facilitating their maintenance of health insurance. Keywords Health insurance; Mental illness; Maternal health; Infant health; MedicaidVirtually all women in the United States have health insurance when their children are born. However, many lose coverage shortly thereafter. For example, in the recent Fragile Families and Child Wellbeing birth cohort survey of urban (mostly unmarried) parents, only 1% of births were not covered by public or private health insurance. This high rate of coverage for perinatal services is a direct result of Medicaid eligibility expansions for pregnant women that began in Correspondence to: Kelly Noonan, knoonan@rider.edu. NIH Public Access Author ManuscriptMatern Child Health J. Author manuscript; available in PMC 2011 January 1. Published in final edited form as:Matern Child Health J. 2010 January ; 14(1): 36-46. doi:10.1007/s10995-008-0424-3. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript the late 1980s. One year after they gave birth, however, over one quarter of the Fragile Families mothers were uninsured for health care.Maintaining health insurance coverage can be challenging, particularly for low-income mothers. Public insurance is generally available through three mechanisms: being poor enough to qualify for welfare, being sufficiently disabled to qualify for Supplemental Secu...

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“…Ironically, it was the ANCC who had curbed the practice of the PMH CNS/NP in primary care settings in the early 1990s, as discussed in the previous section. The early 2000s was also a time of Medicaid reduction, something that disproportionately impacted the mentally ill (Rowland, Garfield, & Elias, 2003). The duration of hospital admissions were shortened, units were closed and psychiatric nurses were downsized or moved to other areas of practice (Sabella & Fay-Hillier, 2014).…”

Section: Changes In Psychiatric Treatments In 2000-to-2014mentioning

confidence: 99%