1970s and 1980s would have only affected silent, baby boomer, and oldest generation X individuals (HHS, 2016). In the 1990s, private insurance increased by coverage for alcohol and related services decreased (HHS, 2016), possibly affecting generation X individuals the most. Specifically, between 1991/1992 and 2001/2002 there was a decrease in use of alcohol-related services among white individuals with AUD (Chartier et al., 2011). This decrease was most notable for alcohol or drug programs, mental health services, private health professionals, and mutual aid and was likely due to decreases in private insurance coverage (which white individuals are more likely to have than black or Hispanic individuals) for alcohol treatment services (Chartier et al., 2011). Later, federal policy changes in the 2000s included the Affordable Care Act made seeking private health professionals and outpatient facilities more affordable and have expanded the role of many existing facilities (i.e., community health centers) (HHS, 2016; McClellan, 2015) to improve access to care for AUD. These latest changes likely affected service use patterns for alcohol problems among generation X and millennials the most.
