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.Download