By Kimberly Leonard
May 4, 2016
People with psychological problems have been increasingly gaining health insurance coverage in recent years, but data in a study released Wednesday by the Centers for Disease Control and Prevention raise questions about whether they are also receiving medical care.
Though the study doesn't explicitly name the Affordable Care Act as the impetus behind the increased insurance coverage among those with mental health issues, the law's effects on the uninsured are well-documented, and the analysis covers periods before and after Obamacare's insurance provisions went into effect. The law has increased insurance coverage overall by providing tax-subsized private health insurance to middle- and low-income Americans, and allows the lowest-income people to receive government-funded care under Medicaid. It also treats mental health care as more equal to other medical care.
With greater health care coverage, people are expected to more easily and regularly access medical services, but the CDC analysis suggests that may not be happening. In the past, research has shown that adults with mental health conditions have greater health care needs and are at a higher risk for poor health outcomes. They also historically have more difficulty accessing care.
The latest data come from the National Health Interview Survey – which is based on information collected by the U.S. Census Bureau through personal household interviews – and offer health care-related estimates from 2012 through the first nine months of 2015, during which around 15 million people at least gained health insurance. Today, that number is closer to 20 million.
The analysis focuses on adults between the ages of 18 to 64 with "serious psychological distress," meaning those whose mental health conditions are serious enough to get in the way of their work, schooling or social life.
Its findings show that the percentage of those with mental health issues who lacked insurance coverage decreased by 8.6 percentage points between 2012 and 2015, though each year this group was still more likely to be uninsured than those without such problems.
People with mental health issues also were more likely to have public insurance coverage like Medicaid, rather than private health insurance. Still, private coverage increased by 8.1 percentage points within this group. Yet despite the increase in insurance coverage, the analysis shows that the percentage of people who had a regular place to go for care remained relatively stable.
The same trend was observed for those who had seen a doctor or other health care professional during the past 12 months.
But the percentage of those who saw a mental health professional decreased among those who had mental health needs. The report does not delve into whether they didn't see a professional because they didn't need to, or because they were unable to when they tried.
The authors do note, however, that the trend may be due to more primary care doctors offering mental health services, or to a shortage of mental health providers.
The study also included data about the cost of care. As insurance coverage increased, cost became less of a barrier to getting medical care, though it was still more likely to be one among those who had mental health conditions versus those who did not.
The same trend was observed for prescription medications. Though a lower percentage of people with mental health conditions reported they were unable to afford medications in 2015 than in previous years, they were still five times more likely to face this barrier than people without mental health conditions.