Medicaid waivers and public sector mental health service penetration rates for youth

To assist families of youth with serious emotional disturbance in financing youth's comprehensive care, some states have sought and received Medicaid waivers. Medicaid waivers waive or relax the Medicaid means test for eligibility to provide insurance coverage to nonpoor families for expensive, otherwise out-of-reach treatment for youth with Serious Emotional Disturbance (SED). Waivers promote treatment access for the most troubled youth, and the present study investigated whether any of several Medicaid waiver options-and those that completely omit the means test in particular-are associated with higher state-wide public sector treatment penetration rates. The investigators obtained data from the U.S. Census, SAMHSA's Uniform Reporting System, and the Centers for Medicare and Medicaid Services. Analysis employed random intercept and random slope linear regression models, controlling for a variety of state demographic and fiscal variables, to determine whether a relationship between Medicaid waiver policies and state-level public sector penetration rates could be observed. Findings indicate that, whether relaxing or completely waiving Medicaid's qualifying income limits, waivers increase public sector penetration rates, particularly for youth under age 17. However, completely waiving Medicaid income limits did not uniquely contribute to penetration rate increases. States offering Medicaid waivers that either relax or completely waive Medicaid's means test to qualify for health coverage present higher public sector treatment rates for youth with behavioral health care needs. There is no evidence that restricting the program to waiving the means test for accessing Medicaid would increase treatment access. (PsycINFO Database Record

Business · Environmental health · Health care · Medicaid · Mental health · Political science · Psychiatry · Public health · Public sector · Waiver · Adolescent and Pediatric Healthcare · Healthcare Policy and Management · Law · Medicine · Nursing · Primary Care and Health Outcomes

• The role of Medicaid home and community-based service policies in organizing and financing care for children with severe emotional disturbance

  Open Access•Genevieve Graaf, L R Snowden et al.•Children and Youth Services Review•2017

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• States’ Use of Medicaid Waivers for Children with Behavioral Health Needs is Associated with Lower Rates of Voluntary Child Welfare Placements

  Open Access•Genevieve Graaf, Liwei Zhang et al.•Child and Adolescent Social Work…•2025

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• Medicaid Waiver Adoption for Youth With Complex Behavioral Health Care Needs

  Open Access•Genevieve Graaf, L R Snowden et al.•Journal of Disability Policy…•2020

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• Power failure

  Open Access•Katherine S Button, John P A Ioannidis et al.•Nature Reviews Neuroscience•2013

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• Insurance Status, Use of Mental Health Services, and Unmet Need for Mental Health Care in the United States

  Elizabeth Reisinger Walker, Janet R Cummings et al.•Psychiatric Services•2015

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