Consumer Knowledge of Insurance Coverage of Alcohol Treatment Services in the United States: Changes Since 2015

Aims of this study are to examine (a) whether consumer knowledge about their health insurance coverage for alcohol-related services has changed over time and (b) whether racial, ethnic, and income disparities in known coverage have changed over time.

This was a general population study comparing the 2015 and 2020 National Alcohol Surveys (N = 12,076 combined 2015 and 2020; 7,215 women, 4,858 men). Knowledge of alcohol treatment coverage (insured with coverage, insured without coverage, insured with coverage unknown, uninsured, or insurance status unknown) was estimated and compared for the total sample ages 18-64 and compared separately by subgroups. Multinomial logistic regression was used to formally test changes in knowledge of coverage over time. Regression models were adjusted for sociodemographics, health insurance type, and current alcohol use disorder. All bivariate and multivariable analyses were survey-weighted to account for probability of selection.

Between 2015 and 2020, the prevalence of those reporting being insured without alcohol treatment coverage decreased (-2.8%, p < .001), and the prevalence of those insured with coverage unknown increased (8.1%, p < .001). Compared with White respondents, foreign-born Hispanic respondents were more likely to report being insured without coverage, and Black or African American respondents were less likely to be insured with coverage and had a steeper decrease in knowledge of coverage status over time.

Results suggest some persistent disparities in known alcohol treatment coverage. They also suggest a need for both greater insurance coverage of alcohol-related services and greater efforts by employers, insurers, and practitioners to inform their constituents and increase knowledge about what alcohol-related services are available to them.