amfAR, The Foundation for AIDS Research

amfAR Study Assesses Impact of Medicaid Expansion on the Opioid Epidemic

Published Wednesday, March 26, 2018

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A new amfAR study has found that while opioid prescribing in the Medicaid population has increased in recent years, there is no statistical difference in prescription rates between states that did expand Medicaid and states that did not. The study aimed to assess the impact of the expansion of Medicaid eligibility in the United States on the opioid epidemic, which currently provides coverage for four in 10 non-elderly Americans living with opioid use disorder. Results were recently published online in the American Journal of Public Health.

The analysis also found that Medicaid expansion actually increased access to addiction treatment.

Using Medicaid enrollment and reimbursement data from 2011 to 2016 in all states, amfAR evaluated prescribing patterns of opioids and three Food and Drug Administration–approved medications used in treating opioid use disorders: buprenorphine, naltrexone, and methadone. The data found that per-enrollee rates of buprenorphine and naltrexone increased by more than 200% after states expanded Medicaid eligibility; by contrast, in the states that did not expand eligibility, prescribing rates increased by less than 50%. Prescriptions for methadone decreased in all states in this period, with larger decreases in expansion states.

In an op-ed first published in The Hill, amfAR Policy Associate and lead author of the paper Alana Sharp noted that the findings provide compelling evidence to refute claims made by some Members of Congress that Medicaid has fueled the opioid epidemic. The analysis also underscores that Medicaid is one of the most powerful tools in our arsenal to fight the opioid epidemic, and attempts to discredit its role in improving the lives of Americans living with substance use disorders are counterproductive and not supported by the best available evidence.

To learn more about the opioid epidemic in the U.S., visit