title: Patterns of medicaid disenrollment for youth with mental health problems.
abstract: Young people who receive Medicaid-funded mental health services during the transition to adulthood often face disenrollment from Medicaid without continuity into publicly funded services. This article investigates the longitudinal predictors of these coverage gaps and disenrollment from age 16 to 23 years. Cox regression analyses estimated predictors of time until the first loss of coverage for 180 days or more, and time until final disenrollment with no subsequent reenrollment. Females were much more likely to regain and retain coverage after initial loss. Funding source and diagnoses predicted Medicaid retention differentially by gender. For both genders, funding through Social Security Income or a diagnosis of Mental Retardation/ Developmental Disabilities was related to Medicaid retention. Disenrollment especially affected males precisely at their 18th and 19th birthdays. Nearly one third of females qualified for Medicaid because of pregnancy. Eligibility guidelines relate to retention and loss during the transition to adulthood and may need reevaluation to ensure continuity of care.
authors.affiliation: Division of Public Behavioral Health and Justice Policy, University of Washington, Seattle, WA 98102-3086, USA. pullmann@u.washington.edu
authors.forename: Michael D
authors.initials: MD
authors.lastname: Pullmann
authors.forename: Craig Anne
authors.initials: CA
authors.lastname: Heflinger
authors.forename: Lindsay
authors.initials: L
authors.lastname: Satterwhite Mayberry
mesh_terms: D000293:Adolescent; D004608:Eligibility Determination / Q000191:economics; D005260:Female; D006297:Health Services Accessibility / Q000191:economics*; D006301:Health Services Needs and Demand / Q000191:economics; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics*; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008605:Mental Health Services / Q000191:economics*; D008922:Mississippi; D016016:Proportional Hazards Models; D012737:Sex Factors; D012943:Social Security; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult