Medicaid expansion linked to gains in insurance coverage
Mark Olfson, M.D., M.P.H., from Columbia University in New York City, and colleagues used data for 2008 to 2015 from the National Survey on Drug Use and Health to examine changes in coverage and substance use disorder treatment among low-income adults after the 2014 Affordable Care Act Medicaid expansion.
The researchers observed a decrease in the percentage of low-income expansion state residents with substance use disorders who were uninsured, from 34.4 percent in 2012-2013 to 20.4 percent in 2014-2015; among residents of non-expansion states, the corresponding decrease was from 45.2 to 38.6 percent. In expansion and non-expansion states, there was no corresponding increase in overall substance use disorder treatment.
"The differential increase in insurance coverage suggests that Medicaid expansion contributed to insurance gains, but corresponding treatment gains were not observed," the authors write. "Increasing treatment may require the integration of substance use disorder treatment with other medical services and clinical interventions to motivate people to engage in treatment."
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