With the opioid epidemic continuing, state interest in expanding access to substance use disorder (SUD) services remains high. Medicaid financed 21% of SUD services and 25% of mental health services in 2014. Section 1115 waivers related to behavioral health remain the most frequent type of waiver sought and obtained by states, with most requesting authority to use federal Medicaid funds for services provided in “institutions for mental disease” (IMDs). Since Medicaid’s inception, Congress has prohibited states from using Medicaid funds for IMD services for non-elderly adults. This brief provides new data and answers key questions about the Medicaid IMD payment exclusion as waiver activity continues, and Congress considers legislative changes, including a House bill that would restrict IMD SUD services to those with opioid use disorder, excluding those with other SUDs.
Featured Opioids Resources
This data note describes uninsured nonelderly adults with opioid use disorder, including their demographic characteristics, health status, and access to treatment.
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Related Opioids Resources
- The Role of Community Health Centers in Addressing the Opioid Epidemic
- The Opioid Epidemic and Medicaid’s Role in Facilitating Access to Treatment
- Federal Legislation to Address the Opioid Crisis: Medicaid Provisions in the SUPPORT Act
- How Connecting Justice-Involved Individuals to Medicaid Can Help Address the Opioid Epidemic
- A Look at How the Opioid Crisis Has Affected People with Employer Coverage
- HIV and the Opioid Epidemic: 5 Key Points
- Public Opinion on the Use and Abuse of Prescription Opioids
- Key Healthcare Proposals in Governors’ Proposed Budgets for SFY 2019 from a Preliminary Look at 32 States
- Medicaid and the Opioid Epidemic: Enrollment, Spending, and the Implications of Proposed Policy Changes
- Understanding Who Opioid Users Are Underscores Challenges
- The Washington Post/Kaiser Family Foundation Survey of Long-Term Prescription Painkiller Users and Their Household Members
- 1 in 5 Americans Say They Know Someone Who Has Died from Prescription Painkiller Overdose
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This issue brief provides Medicaid highlights from governors’ proposed budgets for state fiscal year (FY) 2019 (July 1, 2018 through June 30, 2019 in most states). Proposed budgets reflect the priorities of the governor and are often blueprints for the legislature to consider. In total, we reviewed 39 proposed state budgets and text from 46 state of the state speeches. This review revealed that while state revenue collections improved in 2017 compared to 2016, considerable economic and regional variation persists, many states are facing significant budget challenges unrelated to Medicaid such as unfunded pension liabilities or falling oil prices, and the outlook for 2018 remains uncertain due, in part, to the impacts of the 2017 Federal Tax Reform Act.
With deaths from opioid overdose rising steeply in recent years, and a large segment of the population reporting knowing someone who has been addicted to prescription painkillers, the nation’s opioid epidemic affects people across all incomes, ages, and regions. These resources provide analysis and insight into the epidemic, who it…
Analysis: Cost of Treating Opioid Addiction Rose Rapidly for Large Employers as the Number of Prescriptions Has Declined
A new Kaiser Family Foundation analysis finds that while the use of prescription opioids among people with employer-based health coverage has declined to its lowest levels in over a decade, the cost of treating addiction and overdoses has increased sharply. The annual cost of treating opioid addiction and overdose –…
This Kaiser Family Foundation analysis finds that while prescription opioid use among people with private insurance has declined to its lowest levels in over a decade, the cost of treating opioid abuse has increased substantially.
This chart series highlights 5 key things to know about the intersection of the nation’s HIV and opioid epidemics.
State interest in Medicaid Section 1115 behavioral health waivers, including mental health and substance use disorders, remains high. As of November, 2017, there are 15 approved and 11 pending behavioral health waivers in 22 states. This issue brief describes recent waiver activity in four areas: using Medicaid funds to pay for substance use and/or mental health services in “institutions for mental disease” (IMDs), expanding community-based behavioral health benefits, expanding Medicaid eligibility to cover additional people with behavioral health needs, and financing delivery system reforms.
Medicaid Moving Ahead in Uncertain Times: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2017 and 2018
This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. Report findings are drawn from the annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Family Foundation (KFF) and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD). This report examines the reforms, policy changes, and initiatives that occurred in FY 2017 and those adopted for implementation for FY 2018 (which began for most states on July 1, 2017). Key areas covered include changes in eligibility and enrollment, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, covered benefits (including prescription drug policies), and opioid harm reduction strategies.
Medicaid and the Opioid Epidemic: Enrollment, Spending, and the Implications of Proposed Policy Changes
This issue brief provides data on Medicaid enrollment and spending for people with opioid addiction. It then considers this in the context of the Better Care Reconciliation Act.