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Psychiatr Serv. 2013 Jun;64(6):520-6. doi: 10.1176/appi.ps.201200011.

Characteristics of adults with substance use disorders expected to be eligible for Medicaid under the ACA.

Author information

  • 1Department of Health Policy and Management, Yale School of Public Health, New Haven, CT 06520-8034, USA. susan.busch@yale.edu

Abstract

OBJECTIVES:

Provisions in the Affordable Care Act (ACA) are likely to expand access to substance use disorder treatment for low-income individuals. The aim of the study was to provide information on the need for substance use disorder treatment among individuals who may be eligible for Medicaid under the ACA.

METHODS:

The 2008 and 2009 National Survey on Drug Use and Health provided data on demographic characteristics, health status, and substance use disorders for comparison of current low-income Medicaid enrollees (N=3,809) with currently uninsured individuals with household incomes that may qualify them for Medicaid coverage beginning in 2014 (N=5,049). The incomes of the groups compared were 138% of the federal poverty level (133% provided in the ACA plus a 5% income "disregard" allowed by the law).

RESULTS:

The rate of substance use disorders among currently uninsured income-eligible individuals was slightly higher than the rate among current Medicaid enrollees (14.6% versus 11.5%, p=.03). Although both groups had significant unmet need for substance use disorder treatment, the treatment rate among those who needed treatment was significantly lower in the income-eligible group than in the currently enrolled group (31.3% versus 46.8%, p<.01). When the analysis excluded informal care received outside the medical sector, treatment rates among those with treatment needs were much lower in both groups (12.8% in the income-eligible group and 30.7% among current enrollees).

CONCLUSIONS:

Findings suggest that Medicaid insurance expansions under the ACA will reduce unmet need for substance use disorder treatment.

PMID:
23450343
[PubMed - indexed for MEDLINE]
PMCID:
PMC3672321
Free PMC Article
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