Losing insurance and psychiatric hospitalizations

We study the effect of losing insurance on psychiatric -mental health disorder (MHD) and substance use disorder (SUD) -hospital-based care. Psychiatric disorders cost the U.S. over $1T each year and hospitalizations provide important and valuable care for patients with these disorders. We use variation in public insurance coverage (Medicaid) eligibility offered by a large-scale and unexpected disenrollment in the state of Tennessee in 2005 that lead to 190,0 0 0 individuals losing their insurance. Medicaid enrollees are at elevated risk for psychiatric disorders. Following the disenrollment, hospitalizations for SUDs declined by 15.4%. Findings suggest that MHD hospitalizations declined by 4.2%, but the coefficient es-timate is imprecise. The expected financing of hospital care received also changed, with the probability that Medicaid was listed as the expected payer for MHD and SUD hospitaliza-tions declining by 27.5% and 30.8% respectively post-disenrollment. We provide suggestive evidence that psychiatric health declined post-disenrollment. (c) 2022 Elsevier B.V. All rights reserved.