Medicaid insurance expansions between 2017 and 2023 led to a significant increase in access to medication treatment for opioid use disorder, according to Rutgers Health researchers in an April 6 report.
The study, published in JAMA Network Open, found that expanded Medicaid coverage resulted in more people using buprenorphine, a medication for treating opioid use disorder. This comes at a time when fatal overdoses have continued to rise.
Medicaid is a federal and state program providing health coverage for low-income Americans. Since 2014, states could choose whether to expand their Medicaid programs. Forty-one states and the District of Columbia have adopted expansion. The U.S. Centers for Disease Control and Prevention reported that over 80,000 people died from opioid overdoses from October 2023 through September 2024. Because many people with opioid use disorder are low-income adults, expanding insurance coverage can greatly affect how many receive treatment.
"These results arrive at a critical moment for policymakers and health professionals," said Stephen Crystal, coauthor of the study and director of the Rutgers Center for Health Services Research.
Crystal also said some earlier studies on initial Medicaid expansions "did not find major improvements in overall treatment rates, but this new analysis shows that in the current era of treatment policy, where many of the old barriers have been lifted, Medicaid expansion is not just helpful, but essential." Researchers used national prescription data to assess how recent expansions affected access to treatment. They noted that changes such as authorizing outpatient medication use, expanding telehealth services and allowing more clinicians to prescribe treatments made it easier for patients to get care.
Nicole Siegal, lead author of the study and postdoctoral research fellow at Indiana University’s O'Neill School of Public and Environmental Affairs said: "These results could be incredibly important for public policymakers and state governments wrestling with the Medicaid cuts proposed under the recent H.R.1 federal legislation...this study shows that these expansions are having the kind of widespread impact that earlier research suggested might not be possible."
The findings will be presented during the AcademyHealth Annual Research Meeting scheduled from May 30 through June 2 in Seattle.
