economics Paradigm Challenge

Giving more people health insurance sounds great, but it hasn't actually improved their mental health at all.

SSRN · March 17, 2026 · 6405938

Godwin Aipoh

The Takeaway

While Medicaid expansion successfully removed financial barriers and increased doctor visits, it had zero measurable impact on self-reported mental health. This suggests that insurance cards are useless for mental wellness if they aren't backed by a significant increase in the actual number of available therapists and doctors.

From the abstract

This paper examines whether ACA Medicaid expansion improved self-reported mental health among low income non-elderly adults. Using BRFSS data from 2011 to 2019 and a difference-in-differences framework robust to staggered treatment timing, I estimate the effects of expansion on poor mental health days and frequent mental distress. Medicaid expansion increased insurance coverage by about 4 percentage points, reduced cost-related barriers to care by roughly 2 percentage points, and modestly increa