Medicaid Expansion and the Opioid Epidemic: How does increasing health insurance impact the crisis?
Revise and Resubmit, Journal of Policy Analysis and Management.
This study examines the impact of expanded health insurance coverage, resulting from the Patient Protection and Affordable Care Act of 2010, on opioid related mortality. I utilize variation in states’ decisions to expand Medicaid, in the timing of expansion and in the pre-policy uninsured rate at the state and county level. Opioid related mortality data are examined from 1999-2016 using the multiple cause of death files obtained from the Centers for Disease Control. My findings suggest the implementation of Medicaid expansion resulted in about a 30% reduction in heroin deaths, a 26% reduction in other unspecified narcotics deaths and a 14.5% increase in methadone related deaths. My study builds on recent work that shows increases in prescriptions to treat opioid use disorder in expanding states relative to non-expanding states.
Opioid Use Disorder Treatment and Mortality: Evidence from Variation in Services Offered
Working Paper. In this study, I examine the impact that treatment facilities are having on the opioid related death rate within the counties they are located in. I utilize variation in the location of substance abuse treatment facilities and variation in the services offered and insurance type accepted by those facilities to generate causal estimates of the impact of these services on opioid overdose mortality.
The Earned Income Tax Credit, Poverty, and Health
Health Affairs Policy Brief,
With David Simon and Sarah Goodell
The Opioid Epidemic and Unintended Consequences of Supply Side
Work in Progress. Many responses to the opioid epidemic have focused on the supply of prescription opioids. Two recent papers (Alpert et al., 2018, Evans et al., 2018) have documented how the reformulation (creation of an abuse deterrent formula) of OxyContin led to substitution among opioid users from prescription opioids to illicit heroin. In this study, I examine how reformulation of prescription opioids has impacted rates of viral infection including HIV and Viral Hepatitis.