title: Characteristics of adults with substance use disorders expected to be eligible for Medicaid under the ACA.
abstract: OBJECTIVE
  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.
authors: Department of Health Policy and Management, Yale School of Public Health, New Haven, CT 06520-8034, USA. susan.busch@yale.edu
authors: Susan H
authors: SH
authors: Busch
authors: Ellen
authors: E
authors: Meara
authors: Haiden A
authors: HA
authors: Huskamp
authors: Colleen L
authors: CL
authors: Barry
mesh_terms: D000328:Adult; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D014481:United States; D055815:Young Adult