Medicaid coverage gaps hurt those with depression

Lapses in Medicaid coverage can hit hard in people with severe depression. According to a study by Xu Ji, doctoral candidate in health policy and management, patients with disruptions in their Medicaid coverage visited the ER more often and stayed in the hospital longer than those with continuous coverage.

The study also found that breaks in Medicaid coverage were associated with state re-enrollment policies. The disruption rate was significantly lower among beneficiaries living in states with more streamlined re-enrollment policies (i.e., re-enrollment occurs annually) than among those living in states that required more frequent re-enrollment (i.e., every six months or more frequently). Policies that require more frequent re-enrollment can result in coverage lapses, perhaps because a person did not get their paperwork filed in time or because they moved.

Before the Affordable Care Act (ACA), states could, and many did, require beneficiaries to prove eligibility and re-enroll several times a year. The ACA required states to recertify eligibility no more frequently than once a year for those that qualified based on income. The health care proposals before Congress this year included the option of reinstating more frequent recertification. For those with mental health problems, that could be bad news. "Without a constant source of coverage, patients could end up missing visits with their doctors until their depression worsens to the degree that emergency visits and hospitalizations are required," says Ji.