U of M study shows people with mental health problems are more likely to be uninsured or to rely on public insurance

Monday, October 7, 2013

A new University of Minnesota study shows that people with mental health problems are more likely to be uninsured and rely on public insurance than people without mental health problems.

The cost of mental health services continues to be a concern, especially for persons with serious mental health problems who are uninsured. Public insurance coverage, such as Medicaid or Medicare, generally provides people with mental health issues the most affordable means to access needed treatment.

With the implementation of the Affordable Care Act (ACA), many more people with mental health problems will have access to health insurance – particularly in states, liked Minnesota, that have opted to expand their Medicaid programs – and people with mental health problems on public insurance have better access to care and lower cost barriers than the uninsured or those with private health insurance coverage. 

The new study, titled “Access and Cost Barriers to Mental Health Care by Insurance Status,

1999 to 2010,” was led by Kathleen Rowan, a doctoral student in health services research, policy and administration in the School of Public Health’s Division of Health Policy & Management. The study will appear in the October issue of the journal Health Affairs

“Unfortunately, most persons with mental illness do not receive needed care due in part to a lack of health insurance coverage and the cost of treatment,” said Rowan. “Although access has been pretty stable over the past decade, there are still persistent problems with accessing needed care.”

Other key findings:

  • In 2009-10, nearly one-half of persons with the most serious mental health problems were covered by public insurance, compared to only ten percent of adults with no mental health problems
  • Roughly two-thirds of people with serious mental health problems saw a mental health professional recently, compared to 60 percent of persons with private health insurance
  • Among people on public health coverage, roughly one-third of people with serious mental health problems and nearly one-half of people with moderate mental health problems did not see a mental health care professional in the past year
  • No evidence was found in the improvement to access over the past decade for those with public coverage for either moderate or severe problems, or for those with serious problems on private coverage.

“The Affordable Care Act has great promise for expanding insurance coverage for people with mental health problems – both through expansions in Medicaid and private health insurance exchanges” said Donna McAlpine, a co-author of the article.  “But as it rolls out, we need to keep our eye on how it affects access to mental health care and especially costs.”

The study utilized national data from 1999 to 2010 to examine trends in access and cost barriers among the uninsured, those with public coverage (such as Medicaid) and those with private coverage. 

In addition to Rowan, University of Minnesota co-authors included Donna D. McAlpine, Ph.D., associate professor in the School of Public Health’s Division of Health Policy & Management and Lynn Blewett, Ph.D., professor in the University of Minnesota’s School of Public Health, Division of Health Policy & Management, and director of the State Health Access Data Assistance Center (SHADAC).

The research was funded, in part, by a grant from the Integrated Health Interview Series Project at the Minnesota Population Center (National Institute of Health grant nos. RO1HD046697 and R24HD041023).