THURSDAY, Oct. 4, 2018 — A look at past expansions to Medicaid appears to challenge claims that expansion under Obamacare helped fuel the current opioid crisis in the United States.
University of Pennsylvania researchers report that Medicaid expansions actually had the opposite effect, and led to reductions in drug overdose deaths.
“These findings suggest that Medicaid expansions were unlikely to have contributed to the subsequent rise in drug overdose deaths, and may even have been protective,” said study lead author Dr. Atheendar Venkataramani, an assistant professor of medical ethics and health policy.
Medicaid is the publicly funded insurance program for the poor.
“The results should provide reassurance to policymakers who are concerned that state Medicaid expansions, including the recent expansions implemented as part of the Affordable Care Act, promote rises in drug overdose mortality,” Venkataramani said in a university news release.
Critics of the 2010 Affordable Care Act (often referred to as Obamacare) say it helped fueled abuse of prescription painkillers like oxycodone (OxyContin) and morphine, which account for a large proportion of drug-related fatalities.
For this study, the researchers examined 1998-2008 drug overdose death data from the U.S. Centers for Disease Control and Prevention. They compared three states (Arizona, Maine and New York) that expanded Medicaid in 2001-2002 and states that did not expand Medicaid.
Those Medicaid expansions occurred shortly before the spike in overdose deaths nationwide.
Just prior to expanding Medicaid, Arizona, Maine and New York had about 2 fewer overdose deaths per 100,000 people than all non-expansion states. By 2008, the expansion states had about 7 fewer overdose deaths per 100,000 people, the study found.
The researchers also found that just before expansion, Arizona, Maine and New York had about 8 fewer deaths per 100,000 people than adjacent non-expansion states. By 2008, the expansion states had 17 fewer deaths per 100,000 people.
Overall, drug overdose deaths were nearly 20 percent lower in the expansion states than they would have been without Medicaid expansion, according to the study authors.
The findings were published online recently in the Journal of General Internal Medicine.
The study did not examine how Medicaid expansions might have reduced drug overdose deaths, and only observed an association. However, increased access to health care may have improved people’s financial security and mental health, and enabled treatment for substance use disorders, the researchers suggested.
More information
The U.S. National Institute on Drug Abuse has more about the opioid overdose crisis.
Posted: October 2018
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