Psychological Distress and Enrollment in Medicaid.
Adults with poor mental health may want and need insurance to obtain care, but symptoms may impede enrollment into public health insurance. This study compares Medicaid enrollment responses to eligibility expansions by mental health status using a sample of non-elderly adults in both the 2000-2011 Medical Expenditure Panel Survey and the National Health Interview Survey (N = 27,494). The impact of Medicaid income eligibility thresholds (defined as the maximum family income level allowed in each state to be considered eligible for Medicaid) on Medicaid enrollment was estimated from linear regression models allowing for differential enrollment responses by mental and physical health status. Increasing income eligibility thresholds by 100% of the federal poverty level (FPL) was associated with a five-percentage-point increase in the probability of Medicaid enrollment in the non-disabled population under 300% FPL. The enrollment response to Medicaid expansions prior to the Affordable Care Act was stronger for adults symptomatic of psychological distress compared with adults without distress and compared to adults with chronic physical health problems.
Department of Health Policy, Vanderbilt University School of Medicine, 2525 West End Ave Suite 1200, Nashville, TN, 37203, USA.
Gilbert
G
Gonzales
Division of Health Policy & Management, University of Minnesota School of Public Health, 420 Delaware St. SE, MMC 729, Minneapolis, MN, 55455, USA.
Ezra
E
Golberstein
Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Mail Stop #07W41A, 5600 Fishers Lane, Rockville, MD, 20857, USA.
Steven C
SC
Hill
Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Mail Stop #07W41A, 5600 Fishers Lane, Rockville, MD, 20857, USA. samuel.zuvekas@ahrq.hhs.gov.
Samuel H
SH
Zuvekas
D000328:Adult; D004608:Eligibility Determination; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D019458:Insurance Coverage; D016014:Linear Models; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D017057:Medically Uninsured; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act; D011203:Poverty; D013315:Stress, Psychological / Q000191:economics* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
Medical Expenditure Panel Survey; Mental Health Problem; National Health Interview Survey; Physical Health Problem; Poor Mental Health