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Health Serv Res. 2000 April; 35(1 Pt 2): 253–262.
PMCID: PMC1089099

Health insurance may be improving--but not for individuals with mental illness.


OBJECTIVE: To explore the question of how insurance coverage has changed among individuals with mental problems compared to the general population in the last two years. DATA SOURCES: HealthCare for Communities, a national survey to track health system changes. PRINCIPAL FINDINGS: The percentage of uninsured persons in the general population has not changed very much, and more respondents believe that health insurance coverage has improved rather than deteriorated over the years 1996 to 1998. However, among individuals with probable mental health disorders, more have lost insurance in those two years than have gained it and more report decreases in health benefits. Individuals with worse mental health consistently report a deterioration of access to care compared to individuals with better mental health. CONCLUSIONS: Substantial activity has taken place in state and federal legislation to increase the mental health benefits offered by health insurance. Although this activity could have improved health insurance especially for individuals with mental illness, such persons continue to fare significantly worse than the general population.

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Selected References

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  • Carrasquillo O, Himmelstein DU, Woolhandler S, Bor DH. Going bare: trends in health insurance coverage, 1989 through 1996. Am J Public Health. 1999 Jan;89(1):36–42. [PubMed]
  • Cooper PF, Schone BS. More offers, fewer takers for employment-based health insurance: 1987 and 1996. Health Aff (Millwood) 1997 Nov-Dec;16(6):142–149. [PubMed]
  • Frank Richard G, McGuire Thomas G. Parity for mental health and substance abuse care under managed care. J Ment Health Policy Econ. 1998 Dec 1;1(4):153–159. [PubMed]
  • Frank RG, Koyanagi C, McGuire TG. The politics and economics of mental health 'parity' laws. Health Aff (Millwood) 1997 Jul-Aug;16(4):108–119. [PubMed]
  • Fronstin P, Snider SC. An examination of the decline in employment-based health insurance between 1988 and 1993. Inquiry. 1996;33(4):317–325. [PubMed]
  • Ginsburg PB, Gabel JR, Hunt KA. Tracking small-firm coverage, 1989-1996. Health Aff (Millwood) 1998 Jan-Feb;17(1):167–171. [PubMed]
  • Hirschfeld RM, Keller MB, Panico S, Arons BS, Barlow D, Davidoff F, Endicott J, Froom J, Goldstein M, Gorman JM, et al. The National Depressive and Manic-Depressive Association consensus statement on the undertreatment of depression. JAMA. 1997 Jan 22;277(4):333–340. [PubMed]
  • Kronick R, Gilmer T. Explaining the decline in health insurance coverage, 1979-1995. Health Aff (Millwood) 1999 Mar-Apr;18(2):30–47. [PubMed]
  • Sturm R. How expensive is unlimited mental health care coverage under managed care? JAMA. 1997 Nov 12;278(18):1533–1537. [PubMed]
  • Sturm R, Pacula RL. State mental health parity laws: cause or consequence of differences in use? Health Aff (Millwood) 1999 Sep-Oct;18(5):182–192. [PubMed]
  • Sturm R, Gresenz C, Sherbourne C, Minnium K, Klap R, Bhattacharya J, Farley D, Young AS, Burnam MA, Wells KB. The design of Healthcare for Communities: a study of health care delivery for alcohol, drug abuse, and mental health conditions. Inquiry. 1999 Summer;36(2):221–233. [PubMed]
  • Ware JE, Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473–483. [PubMed]
  • Ware J, Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996 Mar;34(3):220–233. [PubMed]

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