Two of the groups that stood to gain the most from the passage of the Affordable Care Act were people of color, and people with mental, behavioral, and substance-abuse issues. The law was intended to expand affordable coverage to minorities who’d historically lacked it, but the ACA also contained provisions requiring that the new insurance plans and expanded coverage that popped up under its auspices cover a range of behavioral-health services, including some substance-abuse treatments.
A recent study from Timothy Creedon at Brandeis University and Benjamin Lê Cook at the Health Equity Research Lab at Cambridge Health Alliance shows that the ACA has actually achieved gains for both groups, despite some real setbacks over its first few years. The ACA has not yet, however, helped ease racial disparities within behavioral health, with most of the significant gains in treatment coming for white patients. In other words, while white patients with behavioral-health issues and minorities with behavioral health-issues gained insurance coverage at similar rates, only white patients saw that increased coverage resulted in significantly better behavioral- and mental-health treatment.
Creedon and Cook’s work uses data from the National Survey on Drug Use and Health and examines coverage, mental-health treatment, substance-abuse treatment, insurance coverage, and barriers to access among people with substance-abuse disorders or serious psychological distress. What they found on the insurance coverage front was similar to what other analyses have found among the general population. Overall coverage in this group rose to a 10-year high of 81.5 percent in 2014, with the highest rates among whites, but with blacks, Hispanics, and Asian Americans all seeing signifiant increases in coverage after the ACA’s passage, as well. Although the research does not show any shift in the racial-coverage disparity between whites and people of color, the overall coverage gains for this underserved group of people with behavioral-health issues should result in better treatment across races.