A new study by researchers at the Yale School of Public Health reveals an unexpected consequence of the Affordable Care Act’s (ACA) tobacco surcharges: High surcharges resulted in lower rates of insurance enrollment among smokers in the first year of the ACA’s implementation, without increasing smoking cessation. These effects are at odds with the ACA’s mission of universal coverage.
The opioid crisis has captured much recent public attention in the U.S.. But the abuse of substances (licit and illicit) and broader manifestations of mental health have long been central to health policy and to research within HPM. These behaviors are sometimes assessed as markers for population well-being (outgrowths of stigma, discrimination, insecurity or deprivation), sometimes measures of health system performance, yet other times the focus of interventions to improve the quality or equity of that system. Research exploring these issue ranges from efforts to more effectively integrate behavioral health care into primary care, strategies for limiting the harms of abuse, and more foundational studies of the causes or impacts of inadequately treated substance abuse or mental illness.
The use of behavioral health economics to develop programs to encourage people to change health behaviors that lead to substance abuse and mental health issues is at the forefront of HPM’s work. The economics of substance abuse, including alcoholism, illicit drugs such as opioids, smoking and e-cigarettes, as well as obesity, incorporate include lost productivity, cost-effectiveness of treatments, social costs and policy, and drivers behind key disparities.