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Analysis

Medicaid Expansion Linked to Fewer Opioid Deaths

By John Commins  
   January 13, 2020

Medicaid expansion may have prevented up to 8,132 opioid overdose deaths in 2015 to 2017 in the 32 states that expanded Medicaid.

Expanding Medicaid coverage was linked to a 6% drop in opioid overdose deaths nationally, according to new research published in JAMA Network Open.

Researchers NYU Grossman School of Medicine and University of California, Davis, analyzed cause-of-death data from the National Vital Statistics System from 3,109 counties nationwide between 2001 and 2017.

They looked for changes in opioid overdose rates in counties that expanded Medicaid and compared those to changes that occurred in the same time period in counties within states that did not expand Medicaid.

The researchers found that:

  • Medicaid expansion may have prevented between 1,678 and 8,132 opioid overdose deaths in 2015 to 2017 in the 32 states that expanded Medicaid between 2014 and 2016.
     
  • Adoption of Medicaid expansion was associated with a 6% lower rate of total opioid overdose deaths, 11% lower rate of death involving heroin, and a 10% lower rate of death involving synthetic opioids such as fentanyl.
     
  • Medicaid expansion states saw an 11% increase in methadone overdose mortality.

"At a broader level, the findings of this study suggest that providing expanded access to healthcare may be a key policy lever to address the opioid overdose crisis," said study senior author Magdalena Cerdá, director of the Center for Opioid Epidemiology and Policy in the Department of Population Health at NYU Langone Health.

Cerdá said Medicaid beneficiaries are more likely to receive prescriptions for methadone to treat pain, compared to the general population, which increases the risk of overdoses.

The researchers noted that their study's limitations include a reliance on misclassified coding of death certificate data. In addition, the study only looked at deaths among the whole population as opposed to just Medicaid beneficiaries and they did not examine how Medicaid expansion affects access to treatment for opioid use disorder.

“At a broader level, the findings of this study suggest that providing expanded access to healthcare may be a key policy lever to address the opioid overdose crisis. ”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

Adoption of Medicaid expansion was associated with a 6% lower rate of total opioid overdose deaths, 11% lower rate of death involving heroin, and a 10% lower rate of death involving synthetic opioids such as fentanyl.

However, Medicaid expansion states saw an 11% increase in methadone overdose mortality.


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