Optimizing Medicaid policies for persons with mental illness
The implementation of the Affordable Care Act (ACA) will result in major changes in Medicaid coverage for persons with mental illnesses and substance use conditions. Medicaid coverage expansions under the ACA is expected to result in more than 12 million additional Medicaid enrollees and more than 18 million additional persons with private insurance coverage, many of whom have a mental illness (Garfield et al 2011). Medicaid insurance expansions, required parity in mental health and substance use benefits, and other provisions of the ACA offer new opportunities for improving health care systems. Research will be needed to determine whether inpatient and outpatient mental health services are accessible to previously uninsured adults; mental health care is integrated with substance use treatment for individuals with co-occurring mental illness and substance use conditions; and if individuals with mental illness receive needed medical care services and medications. Although there is heterogeneity across states in the degree and nature of Medicaid expansion to new categories of eligible persons, the resulting complex set of new policies and benefit design changes may disproportionately affect vulnerable populations such as persons with mental illness. This session presents novel economics research on three distinct aspects of Medicaid policies. Heterogeneous changes in states’ Medicaid programs provide opportunities for economic research on program designs and their impacts on persons who use mental health care services. Results and discussion can inform existing evaluation efforts and guidance for Medicaid policies nationally.