November 29, 2002

This report looks at the health insurance status of admissions in the 1999 Treatment Episode Data Set (TEDS). TEDS is a compilation of data on the demographic characteristics and substance abuse problems of those admitted for substance abuse treatment. The information comes primarily from facilities that receive some public funding. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once. TEDS includes a Minimum Data Set collected by nearly all States and a Supplemental Data Set collected by some States. Health insurance status is a Supplemental Data Set item on the client's type of health insurance coverage (if any). TEDS does not record whether the health insurance covers substance abuse treatment or whether the insurance was used to pay for treatment. Only data on admissions from the 33 States or jurisdictions with a response rate of 75 percent or higher on this data element in 1999 were used for this report.1 These States or jurisdictions represented 60 percent of TEDS admissions in 1999. Types of Insurance In 1999, the majority (64 percent) of substance abuse treatment admissions reported no health insurance (Table 1). The most frequently reported type of insurance was Medicaid, which accounted for 14 percent of admissions. Private insurance2 was reported by 13 percent of admissions. All other forms of insurance totaled 9 percent. Table 1. Substance Abuse Treatment Admissions, by Type of Health Insurance: 1999 Source: 1999 SAMHSA Treatment Episode Data Set (TEDS). Sex Differences Approximately 33 percent of male admissions reported some form of health insurance compared with 44 percent of female admissions (Table 1). Female admissions were more likely to report Medicaid coverage than male admissions (23 percent vs. 10 percent). There was little difference in the percentage of male and female admissions with private insurance (13 percent vs. 12 percent).

Age Admissions younger than 18 were the group most likely to report health insurance (57 percent) (Figure 1). This age group also had the highest percentage of admissions with private insurance (25 percent) or Medicaid (23 percent). Admissions aged 18 to 24 years old were the group least likely to have health insurance (30 percent). Figure 1. Health Insurance Status, by Age Group: 1999 Source: 1999 SAMHSA Treatment Episode Data Set (TEDS). Race/Ethnicity Asian/Pacific Islander admissions were most likely to report private insurance (21 percent) and least likely to report no insurance (50 percent) (Figure 2). More than 70 percent of American Indian/Alaska Native admissions reported no insurance. The highest rate of no health insurance was among Mexican admissions (81 percent) (data not shown). The highest percentage with Medicaid coverage (31 percent) and the lowest percentage with private insurance (6 percent) was among Puerto Rican admissions. Figure 2. Health Insurance Status, by Race/Ethnicity: 1999 Source: 1999 SAMHSA Treatment Episode Data Set (TEDS). Substance of Abuse Approximately 80 percent of admissions for abuse of stimulants had no insurance (Figure 3). Stimulant admissions were also least likely to have private insurance (6 percent) or Medicaid (8 percent). The largest percentages of private insurance coverage were among admissions for alcohol (16 percent) and marijuana (15 percent). Admissions for opiate abuse had the largest percentage of Medicaid insurance (23 percent). Figure 3. Health Insurance Status, by Primary Substance of Abuse: 1999 Source: 1999 SAMHSA Treatment Episode Data Set (TEDS). Previous Treatment Episodes About 15 percent of admissions with no previous treatment episodes for substance abuse treatment had private insurance (Figure 4). As the number of previous admissions increased, the percentage of admissions with private insurance declined steadily to 7 percent for the group with five or more previous admissions. However, as the number of previous admissions for substance abuse treatment increased, the percentage of admissions with Medicaid increased from 10 percent for those with no previous admissions to 26 percent for the group with five or more previous admissions. Figure 4. Health Insurance Status, by Number of Previous Admissions: 1999 Source: 1999 SAMHSA Treatment Episode Data Set (TEDS). Referral Source More than 72 percent of admissions referred to treatment for substance abuse by the criminal justice system had no insurance (data not shown). Admissions referred by an employer or an Employee Assistance Program had the highest percentage of private insurance (57 percent), but even this group had no insurance one-third of the time. End Notes 1Health insurance is a Supplemental Data Set item reported in 1999 by 33 States and jurisdictions, including AR, AZ, CO, CT, DC, DE, FL, GA, HI, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NE, NH, NJ, ND, NV, PA, SC, TX, UT, and WY. 2For the purposes of this report "Private Insurance" includes Blue Cross/Blue Shield, HMOs, and other forms of private health insurance. The Drug and Alcohol Services Information System (DASIS) is an integrated data system maintained by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). One component of DASIS is the Treatment Episode Data Set (TEDS). TEDS is a compilation of data on the demographic characteristics and substance abuse problems of those admitted for substance abuse treatment. The information comes primarily from facilities that receive some public funding. Information on treatment admissions is routinely collected by State administrative systems and then submitted to SAMHSA in a standard format. Approximately 1.6 million records are included in TEDS each year. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once. The DASIS Report is prepared by the Office of Applied Studies, SAMHSA; Synectics for Management Decisions, Inc., Arlington, Virginia; and RTI, Research Triangle Park, North Carolina. Information and data for this issue are based on data reported to TEDS through April 16, 2001. Access the latest TEDS reports at: www.oas.samhsa.gov/dasis.htm Access the latest TEDS public use files at: http://webapp.icpsr.umich.edu/cocoon/SAMHDA-SERIES/00056.xml Other substance abuse reports are available at: http://www.oas.samhsa.gov The DASIS Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report may be downloaded from   Other reports from the Office of Applied Studies are also available on-line at the OAS home page:   http://www.oas.samhsa.gov.

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