医疗补助计划扩大范围与物质使用障碍的低收入成年人。
Medicaid Expansion and Low-Income Adults with Substance Use Disorders.
机构信息
Department of Psychiatry, College of Physicians and Surgeon, Columbia University, and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, USA.
Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA.
出版信息
J Behav Health Serv Res. 2021 Jul;48(3):477-486. doi: 10.1007/s11414-020-09738-w. Epub 2020 Nov 6.
Problems accessing affordable treatment are common among low-income adults with substance use disorders. A difference-in-differences analysis was performed to assess changes in insurance and treatment of low-income adults with common substance use disorders following the 2014 ACA Medicaid expansion, using data from the 2008-2017 National Surveys on Drug Use and Health. Lack of insurance among low-income adults with substance use disorders in expansion states declined from 34.8% (2012-2013) to 20.0% (2014-2015) to 13.5% (2016-2017) while Medicaid coverage increased from 24.8% (2012-2013) to 48.0% (2016-2017). In nonexpansion states, lack of insurance declined from 44.8% (2012-2013) to 34.2% (2016-2017) and Medicaid coverage increased from 14.3% (2012-2013) to 23.4% (2016-2017). Treatment rates remained low and little changed. Medicaid expansion contributed to insurance coverage gains for low-income adults with substance use disorders, although persistent treatment gaps underscore clinical and policy challenges of engaging these newly insured adults in treatment.
在患有物质使用障碍的低收入成年人中，获得负担得起的治疗的问题很常见。本研究采用 2008-2017 年全国毒品使用和健康调查的数据，采用差异分析评估了 2014 年 ACA 医疗补助扩大后，常见物质使用障碍的低收入成年人的保险和治疗情况的变化。在扩大医疗补助的州，患有物质使用障碍的低收入成年人的保险缺失率从 34.8%（2012-2013 年）下降到 20.0%（2014-2015 年）和 13.5%（2016-2017 年），而医疗补助覆盖范围从 24.8%（2012-2013 年）增加到 48.0%（2016-2017 年）。在非扩大医疗补助的州，保险缺失率从 44.8%（2012-2013 年）下降到 34.2%（2016-2017 年），而医疗补助覆盖范围从 14.3%（2012-2013 年）增加到 23.4%（2016-2017 年）。治疗率仍然很低，几乎没有变化。医疗补助扩大为患有物质使用障碍的低收入成年人提供了保险覆盖的增加，尽管持续存在的治疗差距突显了让这些新获得保险的成年人接受治疗的临床和政策挑战。
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