Medical and Mental Health Services Utilization among Requalified and Former Drug Addiction and Alcoholism Recipients of SSI

Abstract

This article examines the impact of the elimination of the Supplemental Security Income (SSI) drug addiction and alcoholism (DA&A) disability category–-and the consequent loss of Medicaid benefits by most of those terminated from SSI–-on the medical and mental health services utilization of affected individuals. Data are from a two-year, five-wave panel study of a random sample of 1,764 former DA&A recipients in nine sites. Respondents were grouped into three categories: those who requalified for SSI on other grounds: those who lost SSI but obtained alternative health coverage: and those who lost SSI and were uninsured. We found, after controlling for covariates, that the uninsured were significantly less likely than those who requalified for SSI to receive any medical or mental health care. Disparities in care were less pronounced between those who requalified for SSI and those who lost SSI but obtained other coverage. Lack of insurance was associated with greater difficulty in accessing care in four sites, but it was not associated with higher emergency room use.