Health Insurance Status of Adult Substance Abuse Treatment Admissions Aged 26 or Older: 2011

In 2011, an estimated 19.3 million Americans aged 12 or older needed but did not receive substance abuse treatment (SAT). Among the estimated 281,000 people who believed they needed SAT, made an effort to obtain SAT, but ultimately did not receive SAT, the most common reason for not receiving SAT was lack of health insurance & inability to afford the cost of SAT (37.3%); an additional 10.1% said that they had health insurance, but did not cover SAT. The 2011 Treatment Episode Data Set (TEDS), a census of all admissions to treatment facilities reported to the Substance Abuse and Mental Health Services Administration (SAMHSA). Type of health insurance is a data item reported by 34 States and jurisdictions for 2011. Data presented in this report are restricted to those 34 States and jurisdictions. TEDS does not record whether the health insurance covers SAT or whether the insurance was used to pay for SAT. Four categories of health insurance status are used in this report: no health insurance; private insurance, (e.g., Blue Cross/Blue Shield, HMO); Medicaid; & other insurance (e.g., Medicare, CHAMPUS, Tricare). In 2011, 59.6% of SAT admissions aged 26 or older reported having no health insurance, 21.3% reported having Medicaid, and 10.5% reported having private insurance. For admissions aged 26 or older, a higher proportion of male admissions than female admissions reported having no health insurance (63.8 vs. 51.2%). 67.5% of admissions aged 26 or older that were referred to SAT by the criminal justice system had no health insurance, which substantially exceeded the percentages for most other referral sources. The goal of this report is to provide baseline characteristics for health insurance coverage among adults for future comparison. This report shows that prior to the implementation of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (together referred to as the Affordable Care Act, or "ACA"), 3 out of 5 SAT admissions aged 26 or older had no health insurance, and that these admissions differed by several demographic and socio-economic characteristics. With full ACA implementation, access to affordable insurance will increase among the uninsured. As eligibility for Medicaid coverage expands under ACA in many States to those who were not previously eligible (e.g., low-income adults without children and the criminal justice population), the composition of SAT admissions reporting Medicaid coverage might change.