Private Insurance Covers Most Nonelderly Adults with Mental Health Needs

Private insurance supports a large portion of nonelderly adults with mental health conditions and substance use disorders, according to a study by Kaiser Family Foundation (KFF).

Mental health conditions and substance use disorders are common in people of this demographic, many of whom receive assistance from multiple insurers.

In the study, researchers determined that 58 and 57 percent of nonelderly adults with a mental health condition and substance use disorder are covered by private insurance, respectively.

Although private insurance covers more than half of the nonelderly population with mental health conditions and substance use disorders, researchers also noted that Medicaid has the highest share of enrollees with mental health conditions and substance use disorders.

The data showed that about 29 percent of Medicaid beneficiaries are diagnosed with a mental health condition, which is higher than 21 percent of privately insured members who have a mental health condition. About 21 percent of Medicaid beneficiaries have a substance use disorder, higher than the 16 percent of privately insured individuals.

Researchers also found that 11 percent of Medicaid beneficiaries battle both a mental health condition and a substance use disorder, higher than the 7 percent of privately insured individuals who have both conditions.

Researchers noticed a correlation between the presence of a mental health condition or substance use disorder and insurance status. This mainly existed among Medicaid beneficiaries, where those with this type of condition had a higher chance of experiencing chronic diseases and poor health than those who were privately insured.

Looking to the future, the study indicated that recognizing coverage status trends among individuals with mental health conditions and substance use disorders and creating policies to improve access to care by expanding behavioral and mental healthcare benefits in Medicaid is necessary, as many patients would benefit from it.

Various studies from the past indicated that many find mental health benefits highly assistive. For example, a survey from June 2022 stated that most insured Americans reported they had mental healthcare coverage and that most found that their plans fulfilled their mental healthcare needs.

Patients have expressed a high level of satisfaction with coverage through employer-sponsored health plans. Most people engaged in this type of plan experienced ease in connecting with mental healthcare specialists, according to a survey published in May 2022.

Previous studies have also indicated that Medicaid expansion may be necessary to eliminate gaps and create more accessible care for all.

In November 2021, the Kaiser Family Foundation (KFF) noted that the Build Back Better Act could help close the Medicaid coverage gap, however, expansion is necessary to reach permanent coverage.