Department of Public Administration and International Affairs, Syracuse University, Center for Policy Research, Syracuse University, 426 Eggers Hall, Syracuse, NY, 13244-1020, USA.
School of Economics, Huazhong University of Science and Technology, 1037 Luoyu Road, Wuhan, 430074, China.
Soc Sci Med. 2021 Jul;280:113998. doi: 10.1016/j.socscimed.2021.113998. Epub 2021 May 6.
This paper examines the effects of public health insurance expansions on the mental health care utilization and mental and behavioral health of children 6-17 years old. We leverage major expansions in public health insurance eligibility for children and adolescents under Medicaid and the State Children's Health Insurance Program during 1997-2002 to examine mental health care utilization and outcomes for children in the National Survey of America's Families. The study examines these dynamics by gender of children due to their distinct mental health care patterns and risks. The expansions are associated with an estimated 30% reduction in mental health care utilization for girls, but no measurable effect for boys, which may partly be accounted for by increased well-child visits for girls. Mental health improves only for teenagers; boys in particular have an estimated 22 percent increase in their probability of the highest level of health. Parents experience spillovers of lower insurance coverage for themselves - likely from dropping private family coverage for public child-only coverage - but slightly better mental health.
本文探讨了公共医疗保险扩张对 6-17 岁儿童心理健康护理利用和精神及行为健康的影响。我们利用了 1997-2002 年期间医疗补助和州儿童健康保险计划中儿童和青少年公共医疗保险资格的重大扩大，来考察全国美国家庭调查中儿童的心理健康护理利用和结果。由于儿童的心理健康护理模式和风险不同，该研究按儿童的性别来研究这些动态。扩张估计使女孩的心理健康护理利用率降低了 30%，但对男孩没有可衡量的影响，这可能部分归因于女孩的常规健康检查增加。心理健康仅对青少年有所改善；特别是男孩的健康水平估计提高了 22%。父母自身的保险覆盖范围出现外溢效应——可能是因为放弃私人家庭保险转为仅覆盖子女的公共保险——但心理健康略有改善。
