Federal Spending On Behavioral Health Accelerated During Recession As Individuals Lost Employer Insurance

Abstract

The 2007-09 recession had a dramatic effect on behavioral health spending, with the effect most prominent for private, state, and local payers. During the recession behavioral health spending increased at a 4.6 percent average annual rate, down from 6.1 percent in 2004-07. Average annual growth in private behavioral health spending during the recession slowed to 2.7 percent from 7.2 percent in 2004-07. State and local behavioral health spending showed negative average annual growth, -1.2 percent, during the recession, compared with 3.7 percent increases in 2004-07. In contrast, federal behavioral health spending growth accelerated to 11.1 percent during the recession, up from 7.2 percent in 2004-07. These behavioral health spending trends were driven largely by increased federal spending in Medicaid, declining private insurance enrollment, and severe state budget constraints. An increased federal Medicaid match reduced the state share of Medicaid spending, which prevented more drastic cuts in state-funded behavioral health programs during the recession. Federal Medicaid served as a critical safety net for people with behavioral health treatment needs during the recession.

Healthcare access for cancer patients in the era of economic crisis. Results from the HOPE III study

“…On the other hand, the increased cost sharing shifted the financial burden on households and impeded the access especially for patients of low income and high health services use (14)(15)(16) and thus significantly affect the population health outcomes (17).…”

A Review of Health Consequences of Recessions Internationally and a Synthesis of the US Response during the Great Recession

“…In other words, as individuals lost employer insurance, federal spending on Medicaid buffered the impact by increasing spending on behavior health programs, largely comprised of mental health and substance abuse programs. 182 Second, the Oregon health experiment revealed that persons who were randomly assigned to get Medicaid coverage experienced lower rates of clinical depression than those not enrolled, suggesting that access to insurance itself can help buffer against poor mental health outcomes. 183 …”

Spending On Mental And Substance Use Disorders Projected To Grow More Slowly Than All Health Spending Through 2020

“…From 1998 through 2009, average annual growth rates in spending were similar for mental and substance use disorders (6.7 percent) and for all health (6.8 percent). 2 Between 2009 and 2020 we expect to see a return to slower spending growth for the treatment of mental and substance use disorders (4.6 percent annual average increase) than existed in the previous eleven years (6.7 percent) and growth that is slower than the average annual growth in all health spending (5.8 percent). Thus, the downward trend in the share of all health spending for treatment of these conditions-from 7.4 percent in 2009 to 6.5 percent in 2020-is expected to resume.…”

“…The historical spending estimates for mental and substance use disorders have revealed important trends in the financing and delivery of behavioral health treatment in the United States, such as the growth in spending for prescription medications to treat these conditions and the important role played by Medicaid in financing treatment. 1,2 In this article we present spending projections through 2020 that are designed to anticipate how past trends based on data since 1986 may evolve or change in the future. These projections of spending for mental and substance use disorder treatment incorporate trends in spending for provider services and its payer sources as well as the expected impacts of the Affordable Care Act (ACA), both overall and by payer and provider.…”