The Impact of Medicaid Expansion on the Availability of Specialty SUD Treatment Programs in the US

• In Event: Opioid Use Disorder - Treatment and Analysis

Abstract

The expansion of Medicaid extended coverage to approximately 1.6 million individuals with a diagnosis of substance use disorder (SUD), thereby significantly increased the availability of federal resources to treat SUD (Andrews et al. 2019; Saloner & Maclean 2020). However, prior research shows that this expansion prompted some states to cut their own state-level contributions to SUD treatment (Andrews et al., 2023). Given that state funding is the second largest source of funding for SUD treatment after federal funding, it raises the question of whether the concurrent decrease in state funding for SUD treatment accompanied the Medicaid expansion may have mitigated positive effects of Medicaid expansion on the availability of specialty SUD treatment programs. We assess the extent to which Medicaid expansion has increased availability of the various types of SUD treatment programs in the United States. Using data from the Substance Abuse and Mental Health Services Administration's (SAMHSA) Web-based Block Grant Application (WebBGAS) system, we estimate a series of synthetic difference-in-difference regressions (Arkhanglesky et al., 2021), tracking the overall rate of SUD treatment program availability and more granularly the rate of program availability by treatment type (outpatient, intensive outpatient, and residential) from 2010 to 2019. Results show that the availability of specialty SUD treatment programs among Republican states increased following the Medicaid expansion relative to the group of never-expanding states as of 2019. This was the case particularly for residential treatment, the most comprehensive level of care, and for regular outpatient programs, the most broadly provided level of care. In comparison to Democrat expanding states, these changes are even starker, given that in such a comparison, the total availability of this programs is statistically significant.

Authors

• FELIPE ANDRES LOZANO-ROJAS, University of Georgia
  Presenting Author

• Angela Marie Shoulders, University of South Carolina
  Non-Presenting Co-Author