title: Health insurance, health reform, and outpatient mental health treatment: who benefits?
abstract: This research examines how extending health insurance coverage to the previously uninsured impacts outpatient mental health treatment use among adults with different needs. Using data from the Epidemiologic Catchment Area Study and the 1987 National Medical Expenditure Survey, I develop simulations based on estimates of treatment demand. I find that insurance substantially increases demand by the mentally ill, but increased coverage alone cannot meet their treatment needs. Those in better mental health account for significant proportions of additional demand when coverage is expanded. Policies intended to increase access to mental health treatment among targeted groups should carefully consider the costs of increased use by other people.
authors.affiliation: Center for Cost and Financing Studies, Agency for Health Care Policy and Research, Rockville, MD 20852, USA.
authors.forename: S H
authors.initials: SH
authors.lastname: Zuvekas
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000191:economics / Q000706:statistics & numerical data*; D003198:Computer Simulation; D005260:Female; D018166:Health Care Reform; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006305:Health Status Indicators; D006801:Humans; D019458:Insurance Coverage / Q000331:legislation & jurisprudence*; D007358:Insurance, Psychiatric / Q000331:legislation & jurisprudence*; D016018:Least-Squares Analysis; D016015:Logistic Models; D008297:Male; D008484:Medicaid; D017057:Medically Uninsured; D001523:Mental Disorders; D008605:Mental Health Services / Q000191:economics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D008875:Middle Aged; D014481:United States; D019472:Universal Health Insurance