The Relationship Between Medicaid Expansion Under the Affordable Care Act and Suicide Rates Among Individuals Ages 10-24

Abstract

Past research on the effects of Medicaid expansion under the Patient Protection and Affordable Care Act (ACA) on suicide rates has focused on the “expansion population,” or adults up to 138 percent of the federal poverty line (FPL), but little is known about if the effects extend to children and young adults. This paper uses panel data from the U.S. Census Bureau’s American Community Survey (ACS) 1-year Estimates Tables for the years 2013 through 2018 and a U.S. Centers for Disease Control and Prevention (CDC) National Vital Statistics Report to try and produce an unbiased estimate of the relationship between a state’s Medicaid expansion status and suicide rates per 100,000 for children and young adults ages 10 to 24. Multivariate regression analyses using both time and entity fixed effects find mixed results in terms of a statistically significant relationship between expansion status and suicide rates among children and young adults. Although only one of the four regression models finds a statistically significant relationship, all four models in this analysis show evidence that an expanded Medicaid program is associated with lower suicide rates among children and young adults at varying levels of significance. The results of this study could help inform future research on the effect of Medicaid expansion on suicide rates for children and young adults that may uncover more definitive evidence of expansion’s negative association with suicide rates. Any such evidence would help build on the existing research surrounding Medicaid expansion under the ACA and help better understand the program’s viability as a policy lever for suicide prevention.