Medicaid Expansion and Prescription Trends

Abstract

Supplemental Digital Content is available in the text.

Association of Medicaid Expansion With Opioid Overdose Mortality in the United States

“…10,29 Recent evidence demonstrates that compared with nonexpansion states, Medicaid expansion states experienced increases in overall prescriptions for, Medicaidcovered prescriptions for, and Medicaid spending on both MOUDs, particularly buprenorphine and naltrexone, and the opioid overdose reversal medication naloxone. [6][7][8]11,14,30,31,35 Two prior studies 12,16 have found associations between income eligibility expansions for…”

“…Previous research suggests that uptake of medications for opioid use disorder (MOUDs), including methadone, buprenorphine, and extended-release naltrexone, has increased more in expansion states compared with nonexpansion states. [6][7][8][9][10][11] These medications (often in combination with counseling and behavioral therapies) have been linked to improvements in treatment retention and OUD remission as well as reductions, in some cases as high as 50%, in all-cause and overdose-related mortality. 12,13 Medicaid-reimbursed prescriptions for the opioid overdose reversal medication naloxone have also increased significantly more in expansion states compared with nonexpansion states.…”

The opioid crisis and economic distress: Consequences for population change

“…Large predicted population losses associated with overdose deaths make the case for greatly expanded treatment and prevention programs, and for investments in programs that address the underlying economic and sociologic conditions that may contribute to high overdose death rates, and further exacerbate the economic problems in these regions. Potential policy responses include expanding Medicaid coverage to increase access to treatment programs and to naloxone, which can reverse an overdose (Broaddus et al, 2018; Cher et al, 2019; Frank & Fry, 2019; Saloner et al, 2018; Wen et al, 2017). Expanded worker retraining programs and investments in infrastructure like broadband and roads would also help make these places more attractive and help them to transition when industries collapse (Goetz et al, 2018).…”

Effect of the Affordable Care Act on diabetes care at major health centers: newly detected diabetes and diabetes medication management

“…The adoption of the Affordable Care Act (ACA) 1 in the USA expanded health insurance for low-income Americans and took two main forms: Medicaid expansion in some states and subsidized private health insurance through insurance exchanges available in all states, with deep subsidies for persons with incomes from 138% to 250% of the federal poverty limit (FPL) in Medicaid expansion states and from 100% to 250% of the FPL in non-expansion states. Prior studies found a statistically significant slightly negative 2 effects of the ACA on diabetes diagnoses and controversial (from insignificantly slightly positive 3 to significantly positive 4 ) effects on diabetes therapies at county and state levels. We examined the effect of both forms of ACA reform on the improvement of diabetes diagnostics and management in low-income patients who had access to healthcare before the ACA expansion (2011)(2012)(2013).…”

“…The observed trend for the prescribed diabetes medications matched the 2010–2016 dispensed medication trend detected with the Medicaid State Drug Utilization Data. 3 Overall, the reported increase in diabetes medication due to the ACA tended to be modest if a ‘per enrollee’-like measure was selected as opposed to an ‘all prescriptions’ 4 one.…”