• Hefei Wen, Benjamin G Druss, and Janet R Cummings.
• Department of Health Management & Policy, University of Kentucky College of Public Health, Lexington, KY.
• Health Serv Res. 2015 Dec 1; 50 (6): 1787-809.

ObjectiveTo examine the effect of Medicaid expansions on health insurance coverage and access to care among low-income adults with behavioral health conditions.Data Sources/Study SettingNine years (2004-2012) of individual-level cross-sectional data from a restricted-access version of National Survey on Drug Use and Health.Study DesignA quasi-experimental difference-in-differences design comparing outcomes among residents in 14 states that implemented Medicaid expansions for low-income adults under the Section §1115 waiver with those residing in the rest of the country.Data Collection/Extraction MethodsThe analytic sample includes low-income adult respondents with household incomes below 200 percent of the federal poverty level who have a behavioral health condition: approximately 28,400 low-income adults have past-year serious psychological distress and 24,900 low-income adults have a past-year substance use disorder (SUD).Principal FindingsAmong low-income adults with behavioral health conditions, Medicaid expansions were associated with a reduction in the rate of uninsurance (p < .05), a reduction in the probability of perceiving an unmet need for mental health (MH) treatment (p < .05) and for SUD treatment (p < .05), as well as an increase in the probability of receiving MH treatment (p < .01).ConclusionsThe ongoing implementation of Medicaid expansions has the potential to improve health insurance coverage and access to care for low-income adults with behavioral health conditions.© Health Research and Educational Trust.

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