Insurance loss after disenrollment from Medicaid leads to a persistent disruption in the receipt of healthcare services for beneficiaries with mental health disorders.
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‘The largest payer of mental health services in the United States, Medicaid accounts for more than one-fourth of all behavioral health spending. Medicaid expansion under the Affordable Care Act has greatly increased access to treatment for Americans with mental health disorders.
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One-Third Reduction in Outpatient Mental Health Services after Medicaid Disenrollment 
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"Despite the critical role of Medicaid for beneficiaries with mental health disorders, disruptions in Medicaid coverage are common," Dr. Cummings and coauthors write. They note that many factors can lead to Medicaid disenrollment, including income fluctuations and state recertification protocols.
The researchers compared patterns of healthcare use for people with Medicaid disenrollment versus those with continuous coverage. The study used federal data (from the Medical Expenditure Panel Survey, 1999-2015) on approximately 8,800 adults (under age 65) with mental health disorders and at least some Medicaid coverage.
About 32 percent of individuals lost Medicaid coverage and became uninsured at some point. Using their study data, the researchers could follow these individuals while they remained uninsured, for an average of nine months.
Medicaid disenrollment was followed by sustained reductions in healthcare use. There was an average 52 percent relative reduction in the likelihood of receiving any outpatient health service in a month, with a similar reduction in acute health services (emergency visit or hospital admission). The data also showed a 35 percent reduction in the likelihood of receiving any mental health-related outpatient services in a month after disenrollment.
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At a time of ongoing debate over Medicaid expansion, Dr. Cummings and colleagues believe their findings have important policy implications. "When adults with mental health disorders lose Medicaid and become uninsured, elevated out-of-pocket costs may compel [them] to forgo routine treatment," the researchers write. "Reductions in outpatient care...could lead to poor outcomes among those with mental illness."
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Source-Newswise