Medicaid Expansion and Medication Use Among U.S. Children with ASD or ADHD: A Repeated Cross-Sectional Analysis Comparing Before and During the COVID-19 Periods
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND/OBJECTIVES: Children with Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) frequently rely on pharmacological treatment to manage core symptoms. This study examined how Medicaid expansion and the COVID-19 pandemic influenced medication use among children with ASD or ADHD, including those with comorbid diagnoses. METHODS: We analyzed 2016-2023 data from the National Survey of Children's Health (NSCH) for children aged 3-17 years with caregiver-reported diagnoses. Logistic regression models assessed the association between Medicaid expansion, the pandemic period, and current medication use, including an interaction between expansion and pandemic period. Analyses were conducted for the full sample (N = 35,198) and a subgroup with comorbid ASD and ADHD (N = 4298). RESULTS: = 0.4). A significant interaction indicating increased odds of medication use during the pandemic in expansion states was observed only in the full sample, although a similar but non-significant pattern appeared in the comorbid group. Age, race, and insurance-related differences were significant across groups, with coverage consistency playing a larger role in the full sample. Sensitivity analyses, excluding the 2020 survey year and modeling pre/post pandemic periods, supported the robustness of findings. CONCLUSIONS: Medicaid expansion was associated with patterns consistent with buffering pandemic-related disruptions in medication use among children with ASD or ADHD overall, but those with co-occurring conditions remain especially vulnerable.
Source: Healthcare
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $3,258
Funders: Purdue University, Saint Louis University
OpenAlex ID: W7134236565