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Access to health insurance and utilization of public sector substance use treatment: Evidence from the Affordable Care Act dependent coverage provision

Brendan Saloner (), Yaa Akosa Antwi, Johanna Maclean and Benjamin Cook ()
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Brendan Saloner: Department of Health Policy and Management, Johns Hopkins University
Benjamin Cook: Center for Multicultural Mental Health Research, Harvard Medical School

No 1509, DETU Working Papers from Department of Economics, Temple University

Abstract: The relationship between insurance coverage and use of substance use disorders (SUDs) treatment is not well understood. SUD treatment has long been segregated from general medical care, and has had low reliance on private insurance. We examine changes in admissions to publicly-funded, specialty SUD treatment following the implementation of a 2010 Affordable Care Act provision requiring health insurers to offer dependent coverage to young adult children. We compare admissions from the 2007-2012 Treatment Episode Data Set among targeted young adults to older adults. We find that admissions to treatment declined by 11 percent among young adults after the provision. However, the share of young adults covered by private insurance increased by 9.3 percentage points and the share with private insurance as the payment source increased by 6.5 percentage points. This increase was largely offset by decreased self-payment and payment by state and local government sources, followed by decreased Medicaid payment. Public sector providers gained new revenues from private insurers, and the share of patients paying primarily out-of-pocket decreased. Our findings suggest expansions of private insurance may not increase demand for public sector treatment but could provide important revenue for existing patients.

Keywords: Dependent care coverage; Affordable Care Act; health insurance; substance use disorder treatment (search for similar items in EconPapers)
JEL-codes: I13 I11 I18 (search for similar items in EconPapers)
Date: 2015-09
New Economics Papers: this item is included in nep-hea and nep-ias
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