The Affordable Care Act and adults with serious psychological distress: impacts on insurance type, health service use, and health care access during implementation

Jessica Papadopoulos Weaver
2020
Individuals with serious psychological distress (SPD) are significantly more likely to be uninsured or covered by Medicaid, and less likely to have private insurance than individuals with no psychological distress (NPD). They are in worse health and have greater health care needs relative to individuals with NPD, and they are more likely to have difficulties accessing all types of health care. The Affordable Care Act (ACA) sought to improve access to health care primarily through expanding
more » ... ough expanding health insurance coverage, which individuals with SPD often lack. Few studies have examined changes in health insurance status, health services use and access to health care among the SPD population during the time of ACA implementation. Specific aims: The goal of this dissertation is to observe changes to health insurance, health services use, and barriers to health care among individuals with serious psychological distress (SPD) during the time frame of the implementation of the Affordable Care Act (ACA) using the Medical Expenditure Panel Survey. This study aims to answer the following questions: 1a.) "How did health insurance coverage among individuals with SPD shift during ACA implementation?" 1b.) "Did health insurance coverage among individuals with mild-to-moderate psychological distress (MMPD) and no psychological distress (NPD) shift in a similar manner?" 2.) "How did the use of health services shift during ACA implementation among those with SPD and NPD?" 3a.) "How did need for health care and barriers to access of health care change during ACA implementation for individuals with SPD?" 3b.) "Did individuals with MMPD and NPD observe similar changes?". Methods: Mental illness is measured using the Kessler 6 (K6) scale of non-specific psychological distress scale. A score of ≥13 is severe psychological distress (SPD), 12 to 8 is mild to moderate psychological distress (MMPD), and ≤7 is no psychological distress (NPD). Pooled cross-sectional data from the 2011-2016 Integrated Public Use Microdata Series IPUM [...]
doi:10.7282/t3-6ecp-ed45 fatcat:fx7mhrwaazblngyecdadv62dpa