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Published Online: June 2013

Characteristics of Adults With Substance Use Disorders Expected to Be Eligible for Medicaid Under the ACA

Abstract

In states that opt to expand Medicaid, individuals with household income less than 138% of the poverty level will gain access to treatment. To assess unmet need for substance abuse treatment among newly eligible adults, researchers analyzed data from two groups of respondents to the National Survey on Drug Use and Health: low-income Medicaid enrollees and uninsured individuals who will become Medicaid eligible. The rate of substance use disorders was significantly higher in the latter group. Findings suggest that Medicaid expansion will reduce unmet need for treatment.

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.

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Information & Authors

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Published In

Go to Psychiatric Services
Go to Psychiatric Services

Cover: Sir Charles, Alias Willie Harris, by Barkley Leonnard Hendricks, 1972. Oil on canvas. William C. Whitney Foundation, 1973.19.1. National Gallery of Art, Washington, D.C.

Psychiatric Services
Pages: 520 - 526
PubMed: 23450343

History

Published in print: June 2013
Published online: 15 October 2014

Authors

Details

Susan H. Busch, Ph.D.
Dr. Busch is with the Department of Health Policy and Management, Yale School of Public Health, P.O. Box 208034, Suite 300, New Haven, CT 06520-8034 (e-mail: [email protected]). Dr. Meara is with the Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, New Hampshire, and the National Bureau of Economic Research, Cambridge, Massachusetts. Dr. Huskamp is with the Department of Health Care Policy, Harvard Medical School, Boston. Dr. Barry is with the Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore. Some of the data reported here were presented at the AcademyHealth annual research meeting, June 12–14, 2011, Seattle.
Ellen Meara, Ph.D.
Dr. Busch is with the Department of Health Policy and Management, Yale School of Public Health, P.O. Box 208034, Suite 300, New Haven, CT 06520-8034 (e-mail: [email protected]). Dr. Meara is with the Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, New Hampshire, and the National Bureau of Economic Research, Cambridge, Massachusetts. Dr. Huskamp is with the Department of Health Care Policy, Harvard Medical School, Boston. Dr. Barry is with the Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore. Some of the data reported here were presented at the AcademyHealth annual research meeting, June 12–14, 2011, Seattle.
Haiden A. Huskamp, Ph.D.
Dr. Busch is with the Department of Health Policy and Management, Yale School of Public Health, P.O. Box 208034, Suite 300, New Haven, CT 06520-8034 (e-mail: [email protected]). Dr. Meara is with the Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, New Hampshire, and the National Bureau of Economic Research, Cambridge, Massachusetts. Dr. Huskamp is with the Department of Health Care Policy, Harvard Medical School, Boston. Dr. Barry is with the Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore. Some of the data reported here were presented at the AcademyHealth annual research meeting, June 12–14, 2011, Seattle.
Colleen L. Barry, Ph.D., M.P.P.
Dr. Busch is with the Department of Health Policy and Management, Yale School of Public Health, P.O. Box 208034, Suite 300, New Haven, CT 06520-8034 (e-mail: [email protected]). Dr. Meara is with the Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, New Hampshire, and the National Bureau of Economic Research, Cambridge, Massachusetts. Dr. Huskamp is with the Department of Health Care Policy, Harvard Medical School, Boston. Dr. Barry is with the Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore. Some of the data reported here were presented at the AcademyHealth annual research meeting, June 12–14, 2011, Seattle.

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