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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 affects, and how it’s being addressed by federal and state officials and the broader health care system.
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Key Questions about Medicaid Payment for Services in “Institutions for Mental Disease”

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.

The Opioid Epidemic and Medicaid’s Role in Facilitating Access to Treatment

This issue brief provides an overview of Medicaid’s role in addressing the opioid epidemic. It includes information on the characteristics of nonelderly adults with opioid addiction and utilization of different types of treatment services among people with different insurance statuses, and provides an overview of treatment services that are covered by Medicaid. It also discusses the potential implications of the Section 1115 work and premium requirements on states’ ability to address the epidemic.

Governors’ Proposed Budgets for FY 2019: Focus on Medicaid and Other Health Priorities

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.

Opioids

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…

Key Themes in Medicaid Section 1115 Behavioral Health Waivers

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.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.