Evidence map›Paper›PMID 27181735›Full record

ArticlePsychiatric services (Washington, D.C.)2016

The ACA's Dependent Coverage Expansion and Out-of-Pocket Spending by Young Adults With Behavioral Health Conditions.

Mir M Ali, Jie Chen, Ryan Mutter, Priscilla Novak, Karoline Mortensen

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Article in Psychiatric services (Washington, D.C.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Mir M AliDr. Ali and Dr. Mutter are with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (e-mail: mir.ali@samhsa.hhs.gov ). Dr. Chen and Ms. Novak are with the Department of Health Services Administration, School of Public Health, University of Maryland at College Park, College Park, Maryland. Ms. Novak is also an employee of the Agency for Healthcare Research and Quality (AHRQ). Dr. Mortensen is with the Department of Health Sector Management and Policy, School of Business Administration, University of Miami, Coral Gables.
Jie ChenDr. Ali and Dr. Mutter are with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (e-mail: mir.ali@samhsa.hhs.gov ). Dr. Chen and Ms. Novak are with the Department of Health Services Administration, School of Public Health, University of Maryland at College Park, College Park, Maryland. Ms. Novak is also an employee of the Agency for Healthcare Research and Quality (AHRQ). Dr. Mortensen is with the Department of Health Sector Management and Policy, School of Business Administration, University of Miami, Coral Gables.
Ryan MutterDr. Ali and Dr. Mutter are with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (e-mail: mir.ali@samhsa.hhs.gov ). Dr. Chen and Ms. Novak are with the Department of Health Services Administration, School of Public Health, University of Maryland at College Park, College Park, Maryland. Ms. Novak is also an employee of the Agency for Healthcare Research and Quality (AHRQ). Dr. Mortensen is with the Department of Health Sector Management and Policy, School of Business Administration, University of Miami, Coral Gables.
Priscilla NovakDr. Ali and Dr. Mutter are with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (e-mail: mir.ali@samhsa.hhs.gov ). Dr. Chen and Ms. Novak are with the Department of Health Services Administration, School of Public Health, University of Maryland at College Park, College Park, Maryland. Ms. Novak is also an employee of the Agency for Healthcare Research and Quality (AHRQ). Dr. Mortensen is with the Department of Health Sector Management and Policy, School of Business Administration, University of Miami, Coral Gables.
Karoline MortensenDr. Ali and Dr. Mutter are with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (e-mail: mir.ali@samhsa.hhs.gov ). Dr. Chen and Ms. Novak are with the Department of Health Services Administration, School of Public Health, University of Maryland at College Park, College Park, Maryland. Ms. Novak is also an employee of the Agency for Healthcare Research and Quality (AHRQ). Dr. Mortensen is with the Department of Health Sector Management and Policy, School of Business Administration, University of Miami, Coral Gables.

Funding

Effect of Local Health Departments on Health Care Disparities for Individuals with Mental Health DisordersR21MH106813 · NIMH · UNIV OF MARYLAND, COLLEGE PARK · PI CHEN, JIE · 2016 to 2017
$423k
NIMH NIH HHS R21 MH106813
6 · The paper itself

Abstract

objectiveYoung adults with behavioral health conditions (mental or substance use disorders) often lack access to care. In 2010, the Affordable Care Act (ACA) extended eligibility for dependent coverage under private health insurance, allowing young adults to continue on family plans until age 26. The objective of this study was to analyze out-of-pocket (OOP) spending as a share of total health care expenditures for young adults with behavioral health conditions before and after the implementation of the ACA dependent care provision. The study examined the population of young adults with behavioral health conditions overall and by race and ethnicity.

methodsThe study analyzed 2008-2009 and 2011-2012 nationally representative data from the Medical Expenditure Panel Survey with zero-or-one inflated beta regression models in a difference-in-differences framework to estimate the impact of the ACA's dependent coverage expansion. OOP spending was examined as a share of total health care expenditures among young adults with behavioral health disorders. The study compared the treatment group of individuals ages 19-25 (unweighted N=1,158) with a group ages 27-29 (unweighted N=668).

resultsYoung adults ages 19-25 with behavioral health disorders were significantly less likely than the older group to have high levels of OOP spending after the implementation of the ACA's dependent coverage expansion. The reduction was pronounced among young adults from racial-ethnic minority groups.

conclusionsThe extension of health insurance coverage to young adults with behavioral health disorders has provided them with additional financial protection, which can be important given the low incomes and high debt burden that characterize the age group.

Indexed as

Mental DisordersAdultHealth ExpendituresHumansPatient Protection and Affordable Care ActUnited StatesYoung Adult

Identifiers

PMID27181735
PMCPMC6458594

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.