| The 2008 Mental Health Parity and Addiction Equity Act (MHPAEA) established the first federal-level parity coverage of substance use disorders (SUD). Before the MHPAEA, states passed their own SUD parity mandates. In addition, the Patient Protection and Affordable Care Act (PPACA) established Essential Health Benefit (EHB) benchmark plans to further extend SUD parity benefits. The objective of this thesis is to analyze state-level SUD parity mandates as well as the MHPAEA to investigate their effects on SUD treatment admissions and out-of-pocket expenditure burden. A two-way fixed effects approach, akin to the difference-in-differences (DD) framework, is used as the main identification strategy. In addition, an expanded three-way fixed effects approach, akin to the differences-in-differences-in-differences (DDD) framework will be used to identify the effects among those with co-occurring psychiatric and substance abuse conditions. |
