Impact of ACA Health Reforms for People With Mental Health Conditions

Objective: This brief report explores the impact of health reform for people with mental illness. Methods: The Health Reform Monitoring Survey was used to examine health insurance, access to care, and employment for 1,550 people with mental health conditions pre- and post-implementation of the Affordable Care Act (ACA) and by state Medicaid expansion status. Multivariate logistic regressions with predictive margins were used. Results: Post-ACA reforms, people with mental health conditions were less likely to be uninsured (5% versus 13%; t= -6.89, df=50, p<.001) and to report unmet need due to cost of mental health care (17% versus 21%; t=-3.16, df=50, p=.002) and any health services (46% versus 51%; t= - 3.71, df=50, p<.001), and they were more likely to report a usual source of care (82% versus 76%; t=3.11, df=50, p=.002). These effects were experienced in both Medicaid expansion and nonexpansion states. Conclusions: Findings underscore the importance of ACA improvements in the quality of health insurance coverage.