The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act

Johanna Maclean and Brendan Saloner ()
Additional contact information
Brendan Saloner: Johns Hopkins University

No 10745, IZA Discussion Papers from Institute of Labor Economics (IZA)

Abstract: We examine the early effects of U.S. state Medicaid expansions under the Affordable Care Act (ACA) on substance use disorder (SUD) treatment utilization. We couple administrative data on admissions to specialty SUD treatment and prescriptions for medications used to treat SUDs in outpatient settings with a differences-in-differences design. We find no evidence that admissions to specialty treatment changed in expanding states relative to non-expending states. However, post expansion, Medicaid-reimbursed prescriptions for medications used to treat SUDs in outpatient settings increased by 33% in expanding states relative to non-expanding states. Among patients admitted to specialty SUD treatment, we find that in expanding states Medicaid insurance and use of Medicaid to pay for treatment increased by 58% and 57% following the expansion. In an extension to the main analyses we find no evidence that the expansions affected fatal alcohol poisonings or drug-related overdoses. Overall, our findings provide evidence on the early effects of the ACA on SUD treatment utilization with the newly-eligible Medicaid population.

Keywords: Medicaid; public insurance; healthcare; substance use disorders (search for similar items in EconPapers)
JEL-codes: I1 I13 I18 (search for similar items in EconPapers)
Pages: 54 pages
Date: 2017-04
New Economics Papers: this item is included in nep-hea and nep-ias
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Citations: View citations in EconPapers (9)

Published - published in: Journal of Policy Analysis and Management, 2019, 38 (2), 366 - 393

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Related works:
Journal Article: The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act (2019)
Working Paper: The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act (2017)
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