Do expansions in adolescent access to public insurance affect the decisions of substance use disorder treatment providers?

Abstract

We apply a mixed-payer economy model to study the effects of changes in the generosity of children’s public health insurance programs – measured by Medicaid and Children’s Health Insurance Program income thresholds – on substance use disorder (SUD) treatment provider behavior. Using government data on specialty SUD treatment providers over the period 1997–2011 combined with a two-way fixed-effects model and local event study, we show that increases in the generosity of children’s public health insurance induce providers to participate in some, but not all, public markets. Our effects appear to be driven by non-profit and government providers. Non-profit providers also appear to increase treatment quantity slightly in response to coverage expansions.