Reforms that increased insurance coverage in Massachusetts did not increase hospital-based care for young people diagnosed with behavioral health disorders, according to a study by Ellen Meara, Ph.D., of the Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, N.H., and colleagues.

The authors compared inpatient admissions before and after Massachusetts' 2006 health reforms to examine how hospital-based care and insurance coverage changed by studying hospital inpatient and emergency department use from 2003 to 2009.

After 2006, the number of uninsured 19- to 25-year-olds in Massachusetts dropped from 26 percent to 10 percent. Inpatient admission rates for young adults declined an absolute 2 per 1,000 more for primary diagnoses of any behavioral health disorder, 0.38 more for depression and 1.3 more for substance abuse disorders compared to changes observed elsewhere in the U.S. for comparable age groups in the same time period. Emergency department visits for behavioral health diagnoses increased after 2006, but increased less than in Maryland. In addition, hospital behavioral health discharges of people who were uninsured decreased by 5 percentage points for young adult inpatients and 5 percentage points for young adults in the emergency department relative to other states.

"Expanded health insurance coverage for young adults is not associated with large increases in hospital-based care for behavioral health, but it increased financial protection to young adults with behavioral health diagnoses and to the hospitals that care for them," the authors conclude.