Impact of ACA Health Reforms for People With Mental Health Conditions

Thomas, Kelsey R.; Shartzer, Adele; Kurth, Noelle K.; Hall, Jean P.

doi:10.1176/appi.ps.201700044

Cited by 32 publications

(36 citation statements)

References 11 publications

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“…Another possibility is that persons with disabilities living in expansion states were more likely to be employed compared with the same population living in nonexpansion states. 16,20 Possibly this association may have led more persons with a disability to find employment in jobs providing employer-sponsored health insurance in the expansion states, but this hypothesis requires further study.…”

Section: Discussionmentioning

confidence: 99%

“…13,14,15,16,17,18 Moreover, certain populations in need of health care access, including persons with chronic diseases, mental health conditions, and members of racial/ethnic minority groups and immigrants, have seen improvement in access and in outcomes. 19,20,21,22,23…”

Section: Introductionmentioning

confidence: 99%

“…We used a quasi-experimental approach to identify differences in health insurance coverage for persons with a disability by implementation of Medicaid expansion in their state of residence. Based on findings of other studies of the ACA 19,20,21,22,23 and because this population tends to have greater need for health care and the ACA reduced barriers for adults to qualify for Medicaid coverage, we hypothesized that persons with a disability living in Medicaid expansion states would show greater improvement in health insurance coverage compared with persons with a disability living in states that chose not to expand Medicaid.…”

Section: Introductionmentioning

confidence: 99%

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Association of Medicaid Expansion With Health Insurance Coverage Among Persons With a Disability

et al. 2019

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Key Points Question Was the Patient Protection and Affordable Care Act Medicaid expansion associated with an increase in health insurance coverage among persons with a disability? Findings In this cross-sectional analysis of more than 2.5 million US adults aged 26 to 64 years with incomes up to 138% of the federal poverty level, Medicaid expansion was significantly associated with lower uninsurance rates and higher Medicaid and private insurance coverage for persons with a disability. Meaning These findings suggest that Medicaid expansion was associated with improved health insurance coverage among persons with a disability.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of Medicaid Expansion With Health Insurance Coverage Among Persons With a Disability

et al. 2019

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“…Using weighted multiple logistic regression considering demographic information, region, and interactions between burden ratio, region, and insurance status, analogous models for SPD were also built (Katon & Unützer, 2013 ; Mechanic & Olfson, 2016 ; Pratt, 2009 ). Interactions were included to test the hypothesis that regional relationships may be influenced by insurance status and burden ratios, as there are potential regional differences in health care expansion activities (Hibbard & Greene, 2013 ; Thomas et al, 2017 ).…”

Section: Methodsmentioning

confidence: 99%

Regional Differences in Serious Psychological Distress and Overall Physical and Mental Health

Leary

Zachary

Kyeong

2021

Community Ment Health J

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To determine regional differences in the prevalence of overall physical health, overall mental health, and serious psychological distress (SPD). Data from the 2004 to 2016 Medical Expenditure Panel Survey were used for weighted analysis across region. Relationship modifiers considered were sociodemographic factors, health factors, and measures of health expenditures. A higher burden ratio of health care expenditures is negatively associated with health outcomes, across all US regions and insurance. Compared to 2004 values, SPD, overall physical health, and mental health are significantly improved after 2014. This research supports the whole health paradigm, indicating that overall mental and physical health are closely related. The burden of health care costs is an important consideration and related to overall health outcomes, regardless of insurance status or region. These considerations are likely increasingly important to consider with recent global events.

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“…The percentage of LGB adults who were uninsured decreased from 21.7% in 2013 to 11.1% in 2015 (Karpman, Skopec, & Long, 2015). Additionally, Thomas, Shartzer, Kurth, and Hall (2018) estimate that the uninsured rate for people with mental health conditions fell from 13% in 2013 to 5% in 2016. Given the strong evidence for the importance of having health insurance in order to access mental health services (Substance Abuse and Mental Health Services Administration, 2015), these coverage gains have meant increased access for people of color and LGBT people, as well as the QPOC who live at the intersection of these marginalized identities.…”

Section: Mental Health Access and The Acamentioning

confidence: 99%

A Critique of Repealing the Affordable Care Act: Implications for Queer People of Color

Williams

Anderson

2020

Anal Soc Iss & Public Policy

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Public health has expanded health disparities research to include the importance of mental health. Minority stress theory provides a framework for contextualizing these disparities. Queer people of color (QPOC), who are studied far less often than other marginalized groups, face unique distal and proximal stressors as a consequence of their social location. Historically, the healthcare system has served as a conduit for these stressors, with bias and discrimination occurring at interpersonal and structural levels. The Patient Protection and Affordable Care Act (ACA) served to lessen the stressful impact of the healthcare system, specifically by improving access to mental health services for people of color and queer people. The authors utilize a minority stress framework to present information about the separate mental health access gains for people of color and LGBT people and hypothesize about how these gains affect QPOC. This study then uses these gains to frame a discussion about the positive impact of the ACA and discusses the disproportionate impact that repeal of such policy gains could have on the well-being of QPOC. Public health as a discipline has strong roots in social justice and has emerged as a preeminent space for the exploration of health disparities. Examining, and seeking to eliminate, health disparities is inherently an exercise in social justice (Braveman, 2014; Braveman et al., 2011). This effort is wide-ranging and often inter-and transdisciplinary. Public mental health has become a recent area of focus, recognizing the importance of one's mental health in overall well-being, as

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Impact of ACA Health Reforms for People With Mental Health Conditions

Abstract: Findings underscore the importance of ACA improvements in the quality of health insurance coverage.

Cited by 32 publications

References 11 publications

Association of Medicaid Expansion With Health Insurance Coverage Among Persons With a Disability

Association of Medicaid Expansion With Health Insurance Coverage Among Persons With a Disability

Regional Differences in Serious Psychological Distress and Overall Physical and Mental Health

A Critique of Repealing the Affordable Care Act: Implications for Queer People of Color

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