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Medicaid’s Role in Addressing the Opioid Epidemic

Table 1: State Indicators of Medicaid’s Role in Addressing the Opioid Epidemic
State Opioid overdose death rate per 100,000 (2016) Number of opioid-related overdose deaths (2016) Medicaid coverage of MAT drugs (2017) % of total buprenorphine spending financed by Medicaid (2016) IMD exclusion waiver (2018) % of adults age 19-64 with Medicaid (2016)
Prescription opioids Heroin Synthetic opioids, such as fentanyl
Alabama 7.5 94 126 157 B, N 6% No 15%
Alaska 12.5 45 126 N/A M, B, N 34% No 18%
Arizona 11.4 326 299 123 M, B, N 15% Pending 18%
Arkansas 5.9 114 13 38 B* 8% No 15%
California 4.9 955 587 355 M, B, N 16% Approved 22%
Colorado 9.5 212 234 72 M, B, N 25% No 12%
Connecticut 24.5 206 450 500 M, B, N 44% No 17%
Delaware 16.9 31 56 79 M, B, N 40% No 20%
DC 30.0 52 122 129 M, B, N 45% No 22%
Florida 14.4 1,030 669 1,566 M, B, N 5% No 11%
Georgia 8.8 455 226 277 M, B, N 7% No 8%
Hawaii 5.2 44 20 N/A M, B, N 25% No 13%
Idaho 7.4 64 25 20 B, N 13% No 11%
Illinois 15.3 378 1,040 907 B* 15% Pending 15%
Indiana 12.6 231 297 304 M, B, N 17% Approved 17%
Iowa 6.2 82 47 58 B, N 18% No 15%
Kansas 5.1 83 32 27 M, B, N 8% Pending 9%
Kentucky 23.6 403 311 465 B, N 44% Approved 17%
Louisiana 7.7 111 149 89 B, N 8% Approved 19%
Maine 25.2 132 55 199 M, B, N 38% No 17%
Maryland 29.7 666 650 1,091 M, B, N 39% Approved 13%
Massachusetts 29.7 267 630 1,550 M, B, N 49% Approved 21%
Michigan 18.5 560 727 921 M, B, N 13% Pending 19%
Minnesota 7.4 137 149 99 M, B, N 32% No 13%
Mississippi 6.2 97 33 45 M, B, N 4% No 15%
Missouri 15.9 231 380 441 M, B, N 16% No 10%
Montana 4.2 12 N/A 14 M, B, N 7% No 17%
Nebraska 2.4 22 N/A 13 B, N 10% No 8%
Nevada 13.3 235 86 53 M, B, N 12% No 14%
New Hampshire 35.8 69 34 363 M, B, N 18% No 8%
New Jersey 16.0 346 850 689 M, B, N 22% Approved 14%
New Mexico 17.5 153 161 78 M, B, N 30% Pending 28%
New York 15.1 892 1,307 1,641 M, B, N 38% No 21%
North Carolina 15.4 611 544 601 M, B, N 21% Pending 12%
North Dakota 7.6 17 12 15 B, N 17% No 8%
Ohio 32.9 785 1,478 2,296 M, B, N 50% No 19%
Oklahoma 11.2 285 53 98 M, B, N 7% No 11%
Oregon 7.6 128 114 43 M, B, N 24% No 21%
Pennsylvania 18.5 634 926 1,309 M, B, N 29% No 16%
Rhode Island 26.7 89 25 182 M, B, N 50% No 18%
South Carolina 13.1 342 115 237 B, N 12% No 12%
South Dakota 5.0 25 N/A 10 M, B, N 11% No 10%
Tennessee 18.1 679 260 395 B, N 10% No 15%
Texas 4.9 501 530 250 B, N 6% No 8%
Utah 16.4 322 166 72 M, B, N 4% Approved 7%
Vermont 18.4 23 45 53 M, B, N 68% No 17%
Virginia 13.5 343 450 648 M, B, N 13% Approved 7%
Washington 9.4 292 283 93 M, B, N 26% No 18%
West Virginia 43.4 322 235 435 B, N 45% Approved 23%
Wisconsin 15.8 328 389 288 M, B, N 37% Pending 11%
Wyoming 8.7 26 N/A N/A B, N 19% No 8%
NOTES: The three prescriptions for opioid use disorder are methadone, buprenorphine, and naltrexone. Data on coverage of methadone and naltrexone were unavailable for Arkansas and Illinois. Indiana did not cover all three prescriptions in 2017, but reported plans to do so in 2018. Synthetic opioid deaths do not include deaths due to methadone. An IMD (institution for mental disease) is an inpatient facility with over 16 beds.
REFERENCES

Assistant Secretary for Planning and Evaluation, Continuing Progress on the Opioid Epidemic: The Role of the Affordable Care Act, (Washington, DC: Assistant Secretary for Planning and Evaluation, January 2017), https://aspe.hhs.gov/pdf-report/continuing-progress-opioid-epidemic-role-affordable-care-act

Center for Behavioral Health Statistics and Quality, Results from the 2016 National Survey on Drug Use and Health: Detailed Tables (Rockville, MD: Substance Abuse and Mental Health Services Administration, September 2017), https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf

Colleen M. Grogan, et al., “Survey Highlights Differences in Medicaid Coverage for Substance Use Treatment and Opioid Use Disorder Medications,” Health Affairs 35, no. 12 (Dec. 2016):2289-2296, http://content.healthaffairs.org/content/35/12/2289.full

“Health Insurance Coverage of Adults 19-64,” Kaiser Family Foundation, Accessed February 2018, https://www.kff.org/other/state-indicator/adults-19-64

IMS Institute for Healthcare Informatics, Use of Opioid Recovery Medications: Recent Evidence on State Level Buprenorphine Use and Payment Types, (Parsippany, NJ: IMS Institute for Healthcare Informatics, September 2016), https://www.imshealth.com/files/web/IMSH%20Institute/Reports/Healthcare%20Briefs/IIHI_Use_of_Opioid_
Recovery_Medications.pdf

Kaiser Family Foundation analysis of the 2016 National Survey on Drug Use and Health

MaryBeth Musumeci, Key Themes in Medicaid Section 1115 Behavioral Health Waivers (Washington, DC: Kaiser Family Foundation, November 2017), https://www.kff.org/medicaid/issue-brief/key-themes-in-medicaid-section-1115-behavioral-health-waivers/

Medicaid and CHIP Payment and Access Commission, State Policies for Behavioral Health Services Covered Under the State Plan (Washington, DC: Medicaid and CHIP Payment and Access Commission, June 2016), https://www.macpac.gov/publication/behavioral-health-state-plan-services/

National Institute on Drug Abuse, Overdose Death Rates (Bethesda: MD: National Institute on Drug Abuse, January 2017), https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

“Opioid Overdose Deaths by Race/Ethnicity,” Kaiser Family Foundation, Accessed February 2018, https://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-raceethnicity/

“Opioid Overdose Deaths by Type of Opioid,” Kaiser Family Foundation, Accessed February 2018, https://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-type-of-opioid

“Opioid Overdose Death Rates and All Drug Overdose Death Rates per 100,000 population,” Kaiser Family Foundation, Accessed February 2018, https://www.kff.org/other/state-indicator/opioid-overdose-death-rates/

Substance Abuse and Mental Health Services Administration, Medication-Assisted Treatment (Rockville, MD: Substance Abuse and Mental Health Services Administration, November 2016), https://www.samhsa.gov/medication-assisted-treatment

Kathleen Gifford et al., Medicaid Moving Ahead in Uncertain Times: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2017 and 2018 (Washington, DC: Kaiser Family Foundation, October 2017), https://www.kff.org/medicaid/report/medicaid-moving-ahead-in-uncertain-times-results-from-a-50-state-medicaid-budget-survey-for-state-fiscal-years-2017-and-2018/

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