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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
(2015)
Medicaid coverage of opioid use disorder treatments % of total buprenorphine spending financed by Medicaid
(2016)
% of adults age 19-64 with Medicaid
(2015)
Inpatient or detox (2015) Partial hospitalization (2015) Care coordination/ case management (2015) All 3 prescriptions (2017)
Expanded Medicaid/Republican Governor
Arizona 10.2 Yes No Yes Yes 15% 18%
Arkansas 7.2 No No Yes No 8% 15%
Illinois 10.7 Yes No No No 15% 15%
Indiana 8.5 Yes Yes Yes Yes 17% 17%
Iowa 5.8 Yes Yes Yes No 18% 15%
Kentucky 21.0 Yes No No No 44% 17%
Maryland 17.7 No Yes No Yes 39% 13%
Massachusetts 23.3 Yes No No Yes 49% 21%
Michigan 13.6 Yes No Yes Yes 13% 19%
Nevada 6.2 Yes Yes No Yes 12% 14%
New Hampshire 31.3 No Yes Yes Yes 18% 8%
New Jersey 9.8 Yes Yes No Yes 22% 14%
New Mexico 17.9 Yes Yes Yes Yes 30% 28%
North Dakota 4.8 Yes Yes No No 17% 8%
Ohio 24.7 No No Yes Yes 50% 19%
Vermont 13.4 Yes No No Yes 68% 17%
West Virginia 36.0 Yes Yes Yes No 45% 23%
State Average 15.4 13/17 9/17 9/17 11/17 28% 17%
Expanded Medicaid/Democratic or Independent Governor
Alaska 11.0 Yes No Yes Yes 34% 18%
California 4.9 No No No Yes 16% 22%
Colorado 8.7 Yes No Yes Yes 25% 12%
Connecticut 19.2 Yes No Yes Yes 44% 17%
Delaware 14.8 Yes No No Yes 40% 20%
DC 14.5 Yes No Yes Yes 45% 22%
Hawaii 4.1 Yes No Yes Yes 25% 13%
Louisiana 6.3 Yes Yes Yes No 8% 19%
Minnesota 6.2 Yes No Yes Yes 32% 13%
Montana 5.0 Yes No Yes Yes 7% 17%
New York 10.8 Yes No No Yes 38% 21%
Oregon 7.9 Yes No Yes Yes 24% 21%
Pennsylvania 11.2 Yes No Yes Yes 29% 16%
Rhode Island 23.5 No Yes Yes Yes 50% 18%
Washington 9.3 Yes No Yes Yes 26% 18%
State Average 10.5 13/15 2/15 12/15 14/15 30% 18%
Did Not Expand Medicaid/Republican Governor
Alabama 6.1 Yes No No No 6% 15%
Florida 9.4 No No No Yes 5% 11%
Georgia 8.4 Yes Yes No Yes 7% 8%
Idaho 6.0 Yes No Yes No 13% 11%
Kansas 5.4 Yes Yes Yes Yes 8% 9%
Maine 19.3 Yes No No Yes 38% 17%
Mississippi 5.3 Yes No No Yes 4% 15%
Missouri 11.7 Yes No Yes Yes 16% 10%
Nebraska 3.1 Yes No No No 10% 8%
Oklahoma 11.2 Yes No No Yes 7% 11%
South Carolina 11.4 Yes Yes No No 12% 12%
South Dakota 3.5 Yes No No Yes 11% 10%
Tennessee 16.0 Yes No No No 10% 15%
Texas 4.7 Yes No No No 6% 8%
Utah 15.9 No No No Yes 4% 7%
Wisconsin 11.2 Yes Yes No Yes 37% 11%
Wyoming 7.9 Yes Yes Yes No 19% 8%
State Average 9.2 15/17 5/17 4/17 10/17 13% 11%
Did Not Expand Medicaid/Democratic Governor
North Carolina 11.9 Yes Yes No Yes 21% 12%
Virginia 9.9 No No Yes Yes 13% 7%
State Average 10.9 1/2 1/2 1/2 2/2 17% 10%
NOTES: The three prescriptions for opioid use disorder are methadone, buprenorphine, and naltrexone. Prescription drug coverage data for 2017 were unavailable for Arkansas and Illinois, so the data for these states are from 2013. Indiana did not cover all three prescriptions in 2017, but reported plans to do so in 2018. Maine adopted the Medicaid expansion through a ballot initiative in 2017 but has not yet implemented the expansion.
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

Audrey J. Weiss, et al., Opioid-Related Inpatient Stays and Emergency Department Visits by State, 2009-2014 (Rockville, MD: Agency for Healthcare Research and Quality, January 2017), https://www.hcup-us.ahrq.gov/reports/statbriefs/sb219-Opioid-Hospital-Stays-ED-Visits-by-State.pdf

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

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 2015 National Survey on Drug Use and Health

Kaiser Family Foundation, Opioid Overdose Death Rates and All Drug Overdose Death Rates per 100,000 Population (Age-Adjusted), (Washington, DC: Kaiser Family Foundation, 2016), http://kff.org/other/state-indicator/opioid-overdose-death-rates/

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

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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