Changes in depression prevalence among low-income adults due to Medicaid expansion
Open AccessDepression in the US is highly prevalent and incurs high individual and societal costs in suicides, health care spending, and workplace productivity. However, rates of diagnoses and treatment for depression are fairly low compared to other health conditions and despite recent legislation, including the Affordable Care Act (ACA), intended to expand access to mental health care. A literature review on how the prevalence of depression varies by type or presence of health insurance and by gaining or losing insurance coverage produced mixed results, which supports further exploration of the relationship between the prevalence of depression and health insurance coverage. The purpose of this study was to test whether the ACA’s Medicaid expansion was associated with changes in the prevalence of depression among non-elderly, low-income adults by conducting a triple difference analysis of 2010-2017 National Survey of Drug Use and Health data. The analysis also assessed whether Medicaid expansion increased rates of treatment for depression and reduced rates of unmet need for mental health treatment.This triple difference analyses of Medicaid expansion status, before or after the ACA Medicaid expansion was implemented in 2014, and low-income or poor status did not find statistically significant changes in the prevalence of past-year major depressive episode nor for the secondary outcomes of receipt of depression treatment, unmet need for mental health care, and unmet need for mental health care due to cost in the past year among adults with past-year MDE. The results are discussed in the context of other studies of the effect of Medicaid expansion on depression and ideas for future research.
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