Suchergebnisse

The Affordable Care Act's Medicaid expansion provided insurance coverage to many low-income adults with substance use disorders (SUDs), but it is unclear whether this led to more people receiving treatment. We used the Treatment Episode Data Set and a difference-in-differences approach to compare annual rates of specialty treatment admissions in expansion versus nonexpansion states in the period 2010–17. We found that admissions to treatment steadily increased in the four years after Medicaid expansion, with 36 percent more people entering treatment by the fourth expansion year in expansion states compared to nonexpansion states. Changes were largest for people entering intensive outpatient programs and those seeking treatment for opioid use disorder with medication. The share of admissions paid for by Medicaid increased 23 percentage points in expansion states compared to nonexpansion states, largely displacing treatment paid for by state and local governments. The gradual increase in specialty SUD treatment admissions after Medicaid expansion may reflect improving capacity and access to care.

We examine the lifecycle wage effects of health insurance market regulation that compels private insurers to offer continuing coverage to beneficiaries. Using a panel of male workers drawn from the National Longitudinal Survey of Youth 1979, we model wages across the lifecycle as a function of the mandated number of months of continuing coverage at labor market entrance. Access to continuing coverage is plausibly valuable to young workers as this benefit facilities job mobility, which is important for early career wage growth and lifecycle wages, but is costly to firms. We show that more generous mandated continuing coverage at labor market entrance causes an initial wage decline of roughly 1% that reverses after five years in the labor market leading to higher wages later in the career. Wage increases are observable up to 30 years after labor market entrance. We provide suggestive evidence that increased job mobility early in the career is a mechanism for the observed wage effects.

Each year, 10,000 individuals die in alcohol-impaired traffic accidents in the United States, while psychoactive drugs are involved in 20% of all fatal traffic accidents. We investigate whether state parity laws for substance use disorder (SUD) treatment have the unintended benefit of reducing fatal traffic accidents. Parity laws compel insurers to cover SUD treatment in private insurance markets, thereby reducing the financial costs of and increasing access to treatment for beneficiaries. We employ over 20 years of administrative data from the national Fatal Accident Reporting System coupled with a differences-in-differences research design to investigate the potential spillover effects of parity laws to traffic safety. Our findings indicate that passage of a state parity law reduces fatal traffic accident rates by 4.1 to 5.4%. These findings suggest that government regulations requiring insurers to cover SUD treatment can significantly improve traffic safety, possibly by reducing the number of impaired drivers on roadways.