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Insurance expansions and adolescent use of substance use disorder treatment.

OBJECTIVE
To provide evidence on the effects of expansions to private and public insurance programs on adolescent specialty substance use disorder (SUD) treatment use.


DATA SOURCE/STUDY SETTING
The Treatment Episodes Data Set (TEDS), 1996 to 2017.


STUDY DESIGN
A quasi-experimental difference-in-differences design using observational data.


DATA COLLECTION
The TEDS provides administrative data on admissions to specialty SUD treatment.


PRINCIPAL FINDINGS
Expansions of laws that compel private insurers to cover SUD treatment services at parity with general health care increase adolescent admissions by 26% (P < .05). These increases are driven by nonintensive outpatient admissions, the most common treatment episodes, which rise by 30% (P < .05) postparity law. In contrast, increases in income eligibility for public insurance targeting those 6-18 years old are not statistically associated with SUD treatment.


CONCLUSIONS
Private insurance expansions allow more adolescents to receive SUD treatment, while public insurance income eligibility expansions do not appear to influence adolescent SUD treatment.