O'Neill School of Public and Environmental Affairs, Indiana University, Bloomington, Indiana, USA.
Health Econ. 2023 Apr;32(4):755-806. doi: 10.1002/hec.4633. Epub 2022 Dec 8.
This study uses a difference-in-differences design within an event-study framework to examine how state decisions to expand Medicaid following the passage of the Affordable Care Act (ACA) affected mental health treatment. The findings suggest that expansion states experienced increased admissions to mental health treatment facilities and Medicaid-reimbursed prescriptions for medications used to treat common forms of mental illness. The results also indicate an increase in admissions with trauma, anxiety, conduct, and depression disorders. There is also suggestive evidence of an increase in the number of mental health treatment facilities accepting Medicaid as a form of payment. Lastly, as with previous studies, I find weak evidence of a decrease in suicides in Medicaid expansion states. These findings highlight the vital role of the ACA in providing access to mental health treatment for low-income Americans.
本研究采用事件研究框架内的双重差分设计，考察了《平价医疗法案》（ACA）通过后各州扩大医疗补助（Medicaid）的决策如何影响心理健康治疗。研究结果表明，扩大医疗补助范围的州增加了心理健康治疗设施的入院人数，以及用于治疗常见精神疾病的药物的医疗补助报销处方。研究结果还表明，创伤、焦虑、行为和抑郁障碍的入院人数增加。此外，也有迹象表明，接受医疗补助作为支付形式的心理健康治疗设施数量有所增加。最后，与之前的研究一样，我发现医疗补助扩大州的自杀人数略有减少的证据较弱。这些发现突出了 ACA 在为美国低收入人群提供心理健康治疗方面的重要作用。
