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The effect of public health insurance expansions on the mental and behavioral health of girls and boys

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  • Hamersma, Sarah
  • Ye, Jinqi

Abstract

This paper examines the effects of public health insurance expansions on the mental health care utilization and mental and behavioral health of children 6–17 years old. We leverage major expansions in public health insurance eligibility for children and adolescents under Medicaid and the State Children's Health Insurance Program during 1997–2002 to examine mental health care utilization and outcomes for children in the National Survey of America's Families. The study examines these dynamics by gender of children due to their distinct mental health care patterns and risks. The expansions are associated with an estimated 30% reduction in mental health care utilization for girls, but no measurable effect for boys, which may partly be accounted for by increased well-child visits for girls. Mental health improves only for teenagers; boys in particular have an estimated 22 percent increase in their probability of the highest level of health. Parents experience spillovers of lower insurance coverage for themselves – likely from dropping private family coverage for public child-only coverage – but slightly better mental health.

Suggested Citation

  • Hamersma, Sarah & Ye, Jinqi, 2021. "The effect of public health insurance expansions on the mental and behavioral health of girls and boys," Social Science & Medicine, Elsevier, vol. 280(C).
    • Handle: RePEc:eee:socmed:v:280:y:2021:i:c:s0277953621003300
    DOI: 10.1016/j.socscimed.2021.113998
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    References listed on IDEAS

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    1. Hamersma, Sarah & Maclean, Johanna Catherine, 2021. "Do expansions in adolescent access to public insurance affect the decisions of substance use disorder treatment providers?," Journal of Health Economics, Elsevier, vol. 76(C).
    2. Cuellar, Alison Evans & Markowitz, Sara, 2007. "Medicaid policy changes in mental health care and their effect on mental health outcomes," Health Economics, Policy and Law, Cambridge University Press, vol. 2(1), pages 23-49, January.
    3. Lo Sasso, Anthony T. & Buchmueller, Thomas C., 2004. "The effect of the state children's health insurance program on health insurance coverage," Journal of Health Economics, Elsevier, vol. 23(5), pages 1059-1082, September.
    4. Sarah Hamersma & Matthew Kim & Brenden Timpe, 2019. "The Effect Of Parental Medicaid Expansions On Children'S Health Insurance Coverage," Contemporary Economic Policy, Western Economic Association International, vol. 37(2), pages 297-311, April.
    5. David Card & Lara D. Shore-Sheppard, 2004. "Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions on Low-Income Children," The Review of Economics and Statistics, MIT Press, vol. 86(3), pages 752-766, August.
    6. repec:mpr:mprres:2807 is not listed on IDEAS
    7. Gruber, Jonathan & Simon, Kosali, 2008. "Crowd-out 10 years later: Have recent public insurance expansions crowded out private health insurance?," Journal of Health Economics, Elsevier, vol. 27(2), pages 201-217, March.
    8. Hamersma, Sarah & Kim, Matthew, 2013. "Participation and crowd out: Assessing the effects of parental Medicaid expansions," Journal of Health Economics, Elsevier, vol. 32(1), pages 160-171.
    9. Currie, Janet & Decker, Sandra & Lin, Wanchuan, 2008. "Has public health insurance for older children reduced disparities in access to care and health outcomes?," Journal of Health Economics, Elsevier, vol. 27(6), pages 1567-1581, December.
    10. Reiss, Franziska, 2013. "Socioeconomic inequalities and mental health problems in children and adolescents: A systematic review," Social Science & Medicine, Elsevier, vol. 90(C), pages 24-31.
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    Cited by:

    1. Jill Furzer & Maripier Isabelle & Boriana Miloucheva & Audrey Laporte, 2023. "Public drug insurance, moral hazard and children's use of mental health medication: Latent mental health risk‐specific responses to lower out‐of‐pocket treatment costs," Health Economics, John Wiley & Sons, Ltd., vol. 32(2), pages 518-538, February.
    2. Li, Yanan & Sunder, Naveen, 2024. "Distributional effects of education on mental health," Labour Economics, Elsevier, vol. 88(C).
    3. Jill Furzer & Maripier Isabelle & Boriana Miloucheva & Audrey Laporte, 2021. "Public drug insurance and children’s use of mental health medication: Risk-specific responses to lower out-of-pocket treatment costs," CIRANO Working Papers 2021s-34, CIRANO.
    4. Beard, Lauren M. & Choi, Kyung Won, 2024. "Disrupted family reunification: Mental health, race, and state-level factors," Social Science & Medicine, Elsevier, vol. 348(C).

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    More about this item

    Keywords

    Public health insurance; SCHIP and Medicaid thresholds; Mental and behavioral health; Gender differences;
    All these keywords.

    JEL classification:

    • H4 - Public Economics - - Publicly Provided Goods
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • K2 - Law and Economics - - Regulation and Business Law

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