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Access to Health Insurance and Utilization of Substance Use Disorder Treatment: Evidence from the Affordable Care Act Dependent Coverage Provision

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  • Brendan Saloner
  • Yaa Akosa Antwi
  • Johanna Catherine Maclean
  • Benjamin Cook

Abstract

The relationship between insurance coverage and use of specialty substance use disorder (SUD) treatment is not well understood. In this study, we add to the literature by examining changes in admissions to SUD treatment following the implementation of a 2010 Affordable Care Act provision requiring health insurers to offer dependent coverage to young adult children of their beneficiaries under age 26. We use national administrative data on admissions to specialty SUD treatment and apply a difference‐in‐differences design to study effects of the expansion on the rate of treatment utilization among young adults and, among those in treatment, changes in insurance status and payment source. We find that admissions to treatment declined by 11% after the expansion. However, the share of young adults covered by private insurance increased by 5.4 percentage points and the share with private insurance as the payment source increased by 3.7 percentage points. This increase was largely offset by decreased payment from government sources. Copyright © 2017 John Wiley & Sons, Ltd.

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  • Brendan Saloner & Yaa Akosa Antwi & Johanna Catherine Maclean & Benjamin Cook, 2018. "Access to Health Insurance and Utilization of Substance Use Disorder Treatment: Evidence from the Affordable Care Act Dependent Coverage Provision," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 50-75, January.
    • Handle: RePEc:wly:hlthec:v:27:y:2018:i:1:p:50-75
    DOI: 10.1002/hec.3482
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    2. Johanna Catherine Maclean & Brendan Saloner, 2019. "The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(2), pages 366-393, March.
    3. Fone, Zachary S. & Friedson, Andrew I. & Lipton, Brandy & Sabia, Joseph J., 2020. "The Dependent Coverage Mandate Took a Bite Out of Crime," IZA Discussion Papers 12968, Institute of Labor Economics (IZA).
    4. Natt Hongdilokkul & Emanuel Krebs & Xiao Zang & Haoxuan Zhou & Fahmida Homayra & Jeong Eun Min & Bohdan Nosyk, 2021. "The effect of British Columbia's Pharmacare coverage expansion for opioid agonist treatment," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 1222-1238, May.
    5. 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).
    6. Alberto Ortega, 2023. "Medicaid Expansion and mental health treatment: Evidence from the Affordable Care Act," Health Economics, John Wiley & Sons, Ltd., vol. 32(4), pages 755-806, April.
    7. Johanna Catherine Maclean & Brady P. Horn & Jonathan H. Cantor, 2020. "Business Cycles And Admissions To Substance Abuse Treatment," Contemporary Economic Policy, Western Economic Association International, vol. 38(1), pages 139-154, January.
    8. Johanna Catherine Maclean & Justine Mallatt & Christopher J. Ruhm & Kosali Simon, 2022. "The Opioid Crisis, Health, Healthcare, and Crime: A Review of Quasi-Experimental Economic Studies," The ANNALS of the American Academy of Political and Social Science, , vol. 703(1), pages 15-49, September.
    9. Popovici, Ioana & Maclean, J. Catherine & French, Michael, 2017. "The Effects of Health Insurance Parity Laws for Substance Use Disorder Treatment on Traffic Fatalities: Evidence of Unintended Benefits," IZA Discussion Papers 10746, Institute of Labor Economics (IZA).
    10. Sarah Hamersma & Johanna Catherine Maclean, 2018. "Insurance Expansions and Children’s Use of Substance Use Disorder Treatment," NBER Working Papers 24499, National Bureau of Economic Research, Inc.
    11. David Powell & Rosalie Liccardo Pacula, 2021. "The Evolving Consequences of OxyContin Reformulation on Drug Overdoses," American Journal of Health Economics, University of Chicago Press, vol. 7(1), pages 41-67.

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