Medicaid expands against suicides
The new findings were published in the journal JAMA Network Open.
After the Affordable Care Act (ACA) was passed in 2010, all states were required to expand their Medicaid programs to include people earning more than traditionally allowed. system, in addition to groups previously uninsured – adults without children, for example. It is expected that the expansion of Medicaid will significantly reduce the number of Americans without health insurance. The ACA will also provide access to mental health care because states are required to include such coverage in their Medicaid programs.
But in 2012, the US Supreme Court ruled that states don’t need to expand Medicaid if they don’t want to. Today, 39 states have approved Medicaid expansion. The rest are not.
Suicide deaths have been steadily increasing in the US since 1999, with an average annual increase of about 1% from 1999 to 2006, followed by a 2% increase each from 2006 to 2018.
Researchers tracked suicide rates in all 50 states and Washington, DC, from 2000 to 2018, where 553,912 people were reported to have died by suicide. Although the ACA was passed in 2010, states were not able to extend Medicaid eligibility until 2014, so the researchers focused on the years following the expansion from 2015 to 2018.
They hypothesized that better access to mental health care would result from expanded Medicaid eligibility, making it possible for more people to get help when needed. That could prevent some suicides.
The study’s first authors were Hetal Patel, MD, and Justin Barnes, MD, a resident in the Department of Psychiatry and Department of Radiation Oncology at the University of Washington. Working with Bierut and other colleagues, they conducted an analysis to track changes in suicide rates in states before and after expansion and compared those numbers with rates in states that did not. increase access to insurance programs.
From 2011 to 2013, the suicide rate in the states that last extended Medicaid was 13.94 per 100,000 people. In states that did not continue to expand Medicaid, the rate was 16.67 per 100,000. After 2014, the number increased by 2.5 suicides per 100,000 people in Medicaid expansion states. In states that did not expand access, the increase was even larger, 3.1 per 100,000, a statistically significant difference.
The data indicates that there were 0.4 fewer suicides per 100,000 people in states that extended Medicaid between 2014 and 2018, and as a result, the researchers estimated that 1,818 suicides were prevented.
“Increasing access to health care, including mental health care, has helped prevent hundreds of suicide deaths,” said Patel.
Bierut added, “Given the difference we see in this suicide rate, we think there really must be more treatments, as well as subsequent improvements, in mental health in these settings.” states with expanded Medicaid.”