IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v30y2021i6p1306-1327.html
   My bibliography  Save this article

Medicaid expansion and the mental health of college students

Author

Listed:
  • Benjamin W. Cowan
  • Zhuang Hao

Abstract

Reported mental health problems have risen dramatically among US college students over time, as has treatment for these problems. We examine the effect of state‐level Medicaid expansion following the 2014 implementation of the Affordable Care Act on the diagnosis of mental health conditions, psychotropic prescription drug use, and the mental health status of a national sample of college students. We find that students from disadvantaged backgrounds are more likely to report being on public insurance after 2014 in expansion states relative to non‐expansion states, while more advantaged students do not see this increase. Both diagnosis of common mental health conditions and psychotropic drug use increase following expansion for disadvantaged students relative to advantaged ones, which translates into an elimination of the pre‐expansion gap in these outcomes by family background in expansion states. However, in contrast to some recent work on Medicaid expansion and mental health, we do not find that these changes are associated with improvements in self‐reported mental health status. We also do not find that Medicaid expansion has affected risky health behaviors or academic outcomes.

Suggested Citation

  • Benjamin W. Cowan & Zhuang Hao, 2021. "Medicaid expansion and the mental health of college students," Health Economics, John Wiley & Sons, Ltd., vol. 30(6), pages 1306-1327, June.
    • Handle: RePEc:wly:hlthec:v:30:y:2021:i:6:p:1306-1327
    DOI: 10.1002/hec.4256
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.4256
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.4256?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Johanna Catherine Maclean & Michael F. Pesko & Steven C. Hill, 2019. "Public Insurance Expansions And Smoking Cessation Medications," Economic Inquiry, Western Economic Association International, vol. 57(4), pages 1798-1820, October.
    2. Robert Kaestner & Bowen Garrett & Jiajia Chen & Anuj Gangopadhyaya & Caitlyn Fleming, 2017. "Effects of ACA Medicaid Expansions on Health Insurance Coverage and Labor Supply," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(3), pages 608-642, June.
    3. Charles J. Courtemanche & Ishtiaque Fazlul & James Marton & Benjamin D. Ukert & Aaron Yelowitz & Daniela Zapata, 2019. "The Impact of the ACA on Insurance Coverage Disparities After Four Years," NBER Working Papers 26157, National Bureau of Economic Research, Inc.
    4. Henry Saffer & Dhaval Dave, 2005. "Mental Illness and the Demand for Alcohol, Cocaine, and Cigarettes," Economic Inquiry, Western Economic Association International, vol. 43(2), pages 229-246, April.
    5. Jason M. Fletcher, 2008. "Adolescent depression: diagnosis, treatment, and educational attainment," Health Economics, John Wiley & Sons, Ltd., vol. 17(11), pages 1215-1235.
    6. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2018. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health," Southern Economic Journal, John Wiley & Sons, vol. 84(3), pages 660-691, January.
    7. Chorniy, Anna & Currie, Janet & Sonchak, Lyudmyla, 2018. "Exploding asthma and ADHD caseloads: The role of medicaid managed care," Journal of Health Economics, Elsevier, vol. 60(C), pages 1-15.
    8. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker, 2012. "The Oregon Health Insurance Experiment: Evidence from the First Year," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1057-1106.
    9. Charles J. Courtemanche & Daniela Zapata, 2014. "Does Universal Coverage Improve Health? The Massachusetts Experience," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 33(1), pages 36-69, January.
    10. Maclean Johanna Catherine & Cook Benjamin & Carson Nicholas & Pesko Michael F, 2019. "Public Health Insurance and Prescription Medications for Mental Illness," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 19(1), pages 1-25, January.
    11. Fletcher, Jason & Wolfe, Barbara, 2008. "Child mental health and human capital accumulation: The case of ADHD revisited," Journal of Health Economics, Elsevier, vol. 27(3), pages 794-800, May.
    12. Kosali Simon & Aparna Soni & John Cawley, 2017. "The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(2), pages 390-417, March.
    13. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    14. Eisenberg Daniel & Golberstein Ezra & Hunt Justin B, 2009. "Mental Health and Academic Success in College," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 9(1), pages 1-37, September.
    15. Baert, Stijn & Omey, Eddy & Verhaest, Dieter & Vermeir, Aurélie, 2015. "Mister Sandman, bring me good marks! On the relationship between sleep quality and academic achievement," Social Science & Medicine, Elsevier, vol. 130(C), pages 91-98.
    16. Jason M. Fletcher, 2008. "Adolescent depression: diagnosis, treatment, and educational attainment," Health Economics, John Wiley & Sons, Ltd., vol. 17(11), pages 1215-1235, November.
    17. Ed Diener & Derrick Wirtz & William Tov & Chu Kim-Prieto & Dong-won Choi & Shigehiro Oishi & Robert Biswas-Diener, 2010. "New Well-being Measures: Short Scales to Assess Flourishing and Positive and Negative Feelings," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 97(2), pages 143-156, June.
    18. Jason M. Fletcher, 2010. "Adolescent depression and educational attainment: results using sibling fixed effects," Health Economics, John Wiley & Sons, Ltd., vol. 19(7), pages 855-871, July.
    19. Courtemanche, Charles & Marton, James & Ukert, Benjamin & Yelowitz, Aaron & Zapata, Daniela, 2018. "Effects of the Affordable Care Act on Health Behaviors after Three Years," IZA Discussion Papers 11468, Institute of Labor Economics (IZA).
    20. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2017. "Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non‐Expansion States," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(1), pages 178-210, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Joan Costa-Font & Nilesh Raut & Courtney H. Van Houtven, 2024. "Medicaid Expansion and the Mental Health of Spousal Caregivers," Review of Economics of the Household, Springer, vol. 22(3), pages 1047-1084, September.
    2. Jill Furzer & Maripier Isabelle & Boriana Miloucheva & Audrey Laporte, 2023. "Public drug insurance, moral hazard and children's use of mental health medication: Latent mental health risk‐specific responses to lower out‐of‐pocket treatment costs," Health Economics, John Wiley & Sons, Ltd., vol. 32(2), pages 518-538, February.
    3. Jill Furzer & Maripier Isabelle & Boriana Miloucheva & Audrey Laporte, 2021. "Public drug insurance and children’s use of mental health medication: Risk-specific responses to lower out-of-pocket treatment costs," CIRANO Working Papers 2021s-34, CIRANO.
    4. Matt Hampton & Otto Lenhart, 2022. "The effect of the Affordable Care Act Medicaid expansion on marriage," Economic Inquiry, Western Economic Association International, vol. 60(2), pages 568-591, April.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2019. "Effects of the Affordable Care Act on Health Behaviors After 3 Years," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 45(1), pages 7-33, January.
    2. Benjamin W. Cowan & Zhuang Hao, 2020. "Medicaid Expansion and the Mental Health of College Students," NBER Working Papers 27306, National Bureau of Economic Research, Inc.
    3. Lingxiao Wang & Yuqing Zheng & Steven C. Buck, 2021. "How does the affordable care act Medicaid expansion affect cigarette consumption?—The mechanism and heterogeneity," Journal of Consumer Affairs, Wiley Blackwell, vol. 55(3), pages 763-791, September.
    4. Lindsey Rose Bullinger, 2021. "Child Support and the Affordable Care Act's Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(1), pages 42-77, January.
    5. Courtemanche, Charles & Marton, James & Ukert, Benjamin & Yelowitz, Aaron & Zapata, Daniela, 2018. "Effects of the Affordable Care Act on Health Behaviors after Three Years," IZA Discussion Papers 11468, Institute of Labor Economics (IZA).
    6. Aparna Soni, 2020. "The effects of public health insurance on health behaviors: Evidence from the fifth year of Medicaid expansion," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1586-1605, December.
    7. Seonghoon Kim & Kanghyock Koh, 2022. "Health insurance and subjective well‐being: Evidence from two healthcare reforms in the United States," Health Economics, John Wiley & Sons, Ltd., vol. 31(1), pages 233-249, January.
    8. Jacob Vogler, 2020. "Access to Healthcare and Criminal Behavior: Evidence from the ACA Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 39(4), pages 1166-1213, September.
    9. Elena Andreyeva & Benjamin Ukert, 2018. "The impact of the minimum wage on health," International Journal of Health Economics and Management, Springer, vol. 18(4), pages 337-375, December.
    10. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2018. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health," Southern Economic Journal, John Wiley & Sons, vol. 84(3), pages 660-691, January.
    11. Burney, Shaheer & Boehm, Rebecca & Lopez, Rigoberto, 2021. "The impact of the ACA Medicaid expansion on SNAP participation," Food Policy, Elsevier, vol. 101(C).
    12. Cortnie Shupe, 2023. "Public Health Insurance and Medical Spending: The Incidence of the ACA Medicaid Expansion," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(1), pages 137-165, January.
    13. Andrey Aistov & Ekaterina Aleksandrova & Christopher J. Gerry, 2021. "Voluntary private health insurance, health-related behaviours and health outcomes: evidence from Russia," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(2), pages 281-309, March.
    14. Joan Costa-Font & Nilesh Raut & Courtney H. Van Houtven, 2024. "Medicaid Expansion and the Mental Health of Spousal Caregivers," Review of Economics of the Household, Springer, vol. 22(3), pages 1047-1084, September.
    15. Ghosh, Ausmita & Simon, Kosali & Sommers, Benjamin D., 2019. "The Effect of Health Insurance on Prescription Drug Use Among Low-Income Adults:Evidence from Recent Medicaid Expansions," Journal of Health Economics, Elsevier, vol. 63(C), pages 64-80.
    16. McInerney, Melissa & Meiselbach, Mark K., 2020. "Distributional Effects of Recent Health Insurance Expansions on Weight-Related Outcomes," Economics & Human Biology, Elsevier, vol. 38(C).
    17. Cornaglia, Francesca & Crivellaro, Elena & McNally, Sandra, 2015. "Mental health and education decisions," Labour Economics, Elsevier, vol. 33(C), pages 1-12.
    18. Prabal K. De, 2021. "Impacts of insurance expansion on health cost, health access, and health behaviors: evidence from the medicaid expansion in the US," International Journal of Health Economics and Management, Springer, vol. 21(4), pages 495-510, December.
    19. Courtemanche, Charles & Friedson, Andrew & Koller, Andrew P. & Rees, Daniel I., 2019. "The affordable care act and ambulance response times," Journal of Health Economics, Elsevier, vol. 67(C).
    20. Lizhong Peng & Xiaohui Guo & Chad D. Meyerhoefer, 2020. "The effects of Medicaid expansion on labor market outcomes: Evidence from border counties," Health Economics, John Wiley & Sons, Ltd., vol. 29(3), pages 245-260, March.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:30:y:2021:i:6:p:1306-1327. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: https://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.