The Opioid Epidemic Blunted the Mortality Benefit of Medicaid Expansion.

Published

Journal Article

Although the Affordable Care Act's Medicaid expansion reduced uninsurance, less is known about its impact on mortality, especially in the context of the opioid epidemic. We conducted a difference-in-differences study comparing trends in mortality between expansion and nonexpansion states from 2011 to 2016 using the Centers for Disease Control and Prevention mortality data. We analyzed all-cause deaths, health care amenable deaths, drug overdose deaths, and deaths from causes other than drug overdose among adults aged 20 to 64 years. Medicaid expansion was associated with a 2.7% reduction (p = .020) in health care amenable mortality, and a 1.9% reduction (p = .042) in mortality not due to drug overdose. However, the expansion was not associated with any change in all-cause mortality (0.2% reduction, p = .84). In addition, drug overdose deaths rose more sharply in expansion versus nonexpansion states. The absence of all-cause mortality reduction until drug overdose deaths were excluded indicate that the opioid epidemic had a mitigating impact on any potential lives saved by Medicaid expansion.

Full Text

Duke Authors

Cited Authors

  • Yan, BW; Sloan, FA; Boscardin, WJ; Guo, F; Dudley, RA

Published Date

  • May 13, 2020

Published In

Start / End Page

  • 1077558720919620 -

PubMed ID

  • 32403982

Pubmed Central ID

  • 32403982

Electronic International Standard Serial Number (EISSN)

  • 1552-6801

International Standard Serial Number (ISSN)

  • 1077-5587

Digital Object Identifier (DOI)

  • 10.1177/1077558720919620

Language

  • eng