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Mental health and substance use problems happen the most during young adulthood. According to a new study in Health Affairs, Obamacare may be helping with those disorders.
Mental health treatment climbed 5.4 percentage points for 18-25 year olds when compared to a similar group of young adults aged 26-35, who were too old to benefit from the expansion of dependent coverage. And the proportion of 18-25 year olds who reported that private insurance paid their mental health bills climbed by about 13 percentage points. This was a substantial change; before the under-26 policy went into effect, nearly 60 percent of 18-25 year olds reported that insurance didn't pay for the mental health services they received.
Obamacare's under-26 coverage is having an impact
Considering most of it just went into effect this year, we can't say much about the health impacts of Obamacare yet. But this adds to a growing base of evidence that the health law is improving the health and well-being of young adults.
The part of Obamacare that required insurers to extend dependent coverage up to age 26 — instead of terminating coverage at 18 or 24, depending on whether a kid enrolled in college — went into effect in 2010. That means we've accrued enough data through start parsing some of those effects.
In this study, researchers used a national survey to key in on young adults who had reported serious psychological distress in the previous year, believing this population in particular might seek out mental health and substance abuse services.
While the gains in mental health treatment were significant, the researchers did not observe a change in the utilization patterns for substance abuse services. It's possible that this reflects gendered patterns in how patients use health care: 62 percent of the "at risk" population for mental health services was female, compared to only 38.5% of the population who might be suffering from substance use disorders.
Health reform may not explain all of the improvements
To be fair, the Affordable Care Act may not be the only thing at play. "We're talking about a time period during which a lot of stuff is going on," said Brendan Saloner, a professor of health policy at Johns Hopkins University and the study's lead author. In 2008, a federal law went into effect that mandated mental health parity, meaning insurers had to make their mental health benefits comparable to traditional or physical health benefits. That could have increased access to mental health care, though it shouldn't have affected the different age groups in different ways. And it's tough to tease out the effects of the recession and recovery from the implementation of this Obamacare provision.
But, broadly speaking, these results are in line with what we'd expect based on prior research. Research on a large employer-sponsored plan found that newly-covered dependents (beneficiaries of the same Obamacare provision) were more likely to use mental health and substance abuse treatment than peers of the same age who had the insurance coverage in their own name, rather than as a dependent. And in Oregon, when low-income adults were randomly assigned the chance to enroll in Medicaid, health coverage through the public insurance program substantially decreased the rate of depression.
