Mental Health Insurance In The 1990s: Are Employers Offering Less To More?

Jensen, Gail A.; Rost, Kathryn; Burton, Russell P. D.; Bulycheva, Maria

doi:10.1377/hlthaff.17.3.201

Cited by 49 publications

(26 citation statements)

References 4 publications

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“…In particular, competition may induce firms to offer similar benefits in their health plans in order to attract quality employees. This theory is consistent with past research showing self-insured firm plans having similar benefits and costs as those that were not self-insured (Acs et al, 1996;Jensen et al, 1998;Gabel et al, 2003). Nevertheless, in the context of our study, the limitation to the states' authority has an important implication: it leaves scope for the federal government's ACA mandate to increase health insurance access to young adults, even in states with pre-existing mandates.…”

supporting

confidence: 91%

A Reevaluation of the Effects of State and Federal Dependent Coverage Mandates on Health Insurance Coverage

2018

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State governments have been passing laws mandating insurers to allow young adults to stay on their parents' health insurance plans past the age of 19 since the 1970s. These laws were intended to increase coverage, but research has been inconclusive on whether they were successful. We reconsider the issue with an improved approach featuring three key elements: a new, accurate dataset on state mandates; recognition that effects could differ greatly by age due to take up rate differences; and avoidance of endogenous characteristics when identifying mandate eligible young adults. We find the impact of the state mandates was concentrated among the 19 to 22 age group, for which dependent coverage increased sharply by about 6 percentage points. Overall coverage increased by almost 3 percentage points, with the difference explained by crowd out of public insurance. Crowd out of coverage through young adults own jobs was negligible. For those above age 22, we find little evidence of changes in coverage. We incorporate these insights into analysis of the Affordable Care Act (ACA) dependent coverage mandate, showing its effects were focused among those whom were previously ineligible for state mandates, or were eligible but older than 22. We argue the ACA's impact was broader because it had fewer eligibility conditions that implied parental dependence; young adults could be on their parents' insurance but still be relatively independent.

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supporting

confidence: 91%

A Reevaluation of the Effects of State and Federal Dependent Coverage Mandates on Health Insurance Coverage

2018

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“…Most private plans do provide some coverage for mental health/substance abuse services, but the coverage is generally limited (Buck et al 1999, Jensen et al 1998. Public mental health care is financed primarily through Medicaid and Medicare and provides for those lacking in private insurance, primarily individuals with chronic or long-term mental health care needs.…”

Section: Resultsmentioning

confidence: 99%

Rethinking professional prerogative: managed mental health care providers

Scheid¹

2000

Sociology Health & Illness

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Managed care represents a response to the wider institutional demand for technical rationality and efficiency. In the US, managed care exemplifies the commodification of health and is governed by a technocratic-rationality that often conflicts with the professionally governed value rationality of providers. Providers must negotiate between contradictory institutional demands for cost containment and quality care in their everyday work practices, and consequently experience a series of ethical dilemmas. This paper examines the effect the commodification of health care has had upon the work of mental health care providers, their loss of professional prerogative, their concrete experience of the ethical dilemmas which result from the commodification of care, and evidence of countervailing power.

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“…, for example, find that while health care costs per employee grew from 1989 to 1995, mental health care costs decreased in absolute terms and as a fraction of employers' total medical plan expenses. Jensen et al (1998) find that while the proportion of employees with mental health care coverage increased over the period 1991-95, coverage came with significant limitations for most. Buck et al (1999) report that restrictions on mental health coverage were substantial for most individuals as of 1997.…”

Section: Mental Health Parity Backgroundmentioning

confidence: 88%

Subsidizing Addiction: Do State Health Insurance Mandates Increase Alcohol Consumption?

Klick

Stratmann

2006

The Journal of Legal Studies

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A model of addiction in which individuals are forward looking implies that as the availability of addiction treatment options grows, individuals will consume more of an addictive good.We test this implication using cross-state variation in the adoption of mental health parity mandates that include substance abuse treatments. We examine the effects of these mandates on the consumption of alcohol and find that parity legislation leads to an increase in alcohol consumption. To account for the possible endogeneity of the adoption of mental health parity mandates, we perform an instrumental variables analysis and find that the ordinary least squares estimation significantly underestimates the insurance effect on alcohol consumption.

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Mental Health Insurance In The 1990s: Are Employers Offering Less To More?

Cited by 49 publications

References 4 publications

A Reevaluation of the Effects of State and Federal Dependent Coverage Mandates on Health Insurance Coverage

A Reevaluation of the Effects of State and Federal Dependent Coverage Mandates on Health Insurance Coverage

Rethinking professional prerogative: managed mental health care providers

Subsidizing Addiction: Do State Health Insurance Mandates Increase Alcohol Consumption?

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