Early Medicaid Expansions and Drug Overdose Mortality in the USA: a Quasi-experimental Analysis
The widespread availability of prescription and illicit opioids is thought to be a key driver of the rise in drug overdose mortality in the USA.1 The role of health insurance in increasing access to prescription opioids has thus emerged as a key policy issue. Policymakers and commentators have raised concerns that Medicaid expansions—such as those implemented as part of the Affordable Care Act (ACA)—may have caused the rise in drug overdose mortality, citing more deaths from drug overdose in states that expanded Medicaid versus those that did not.2
Assessing whether insurance expansions helped cause the rise in drug overdose mortality is challenging in the midst of a national crisis. The availability of opioids1 and drug overdose mortality rates3 were already increasing prior to the ACA. In addition, the crisis has evolved like an epidemic and assessing root causes is difficult during periods of accelerating growth in disease rates.
We examined the effect of Medicaid...
KEY WORDSdrug overdose mortality opioid crisis Medicaid USA quasi-experimental
No specific funding was received for this study. ASV reports salary support from the National Institutes of Health (Mentored Career Development Award, grant K23MH106362).
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
- 2.Finley A. Does Medicaid spur opioid abuse? Wall Street J. 2017;Sept. 24. https://www.wsj.com/articles/does-medicaid-spur-opioid-abuse-1506289279.
- 3.Goodman-Bacon A, Sandoe E. Did Medicaid expansion cause the opioid epidemic? There’s little evidence that it did. Health Affairs Blog. 2017.Google Scholar