The Opioid Epidemic and Medicaid’s Role in Treatment: A Look at Changes Over Time
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The Opioid Epidemic and Medicaid’s Role in Treatment: A Look at Changes Over Time
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The Opioid Epidemic and Medicaid’s Role in Treatment: A Look at Changes Over Time
- 1. The Opioid Epidemic and Medicaid’s Role in Treatment: A Look at Changes Over Time
- 2. Figure 2 • The US is facing an unprecedented opioid epidemic, which has resulted in increases health care services utilization and a surge in overdose deaths. • Medicaid plays an important role in addressing the epidemic, covering 3 in 10 people with opioid addiction in 2015. • However, the proposed changes to Medicaid as proposed in Better Care Reconciliation Act could set back states’ efforts to address the epidemic.
- 3. Figure 3 SOURCE: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Results from the 2005 National Survey on Drug Use and Health. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration Results from the 2015 National Survey on Drug Use and Health: Detailed Tables From 2005 to 2015, the number of people with heroin and prescription opioid addiction increased substantially. 227k 1.5M 359k 1.9M 591k 2M Heroin Prescription Opioid 2005 2010 2015
- 4. Figure 4 SOURCE: 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, December 2016), https://www.hcup-us.ahrq.gov/reports/statbriefs/sb219- Opioid-Hospital-Stays-ED-Visits-by-State.jsp Opioid-related inpatient stays and emergency department visits also increased dramatically during this time. 136.8 89.1 197.1 117.5 224.6 177.7 Inpatient Stays (per 100,000) Emergency Department Visits (per 100,000) 2005 2010 2014
- 5. Figure 5 SOURCE: Kaiser Family Foundation analysis of Centers for Disease Control and Prevention (CDC), National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database In 2005, about half of states had an opioid overdose death rate less than 5.0/100,000, and the states with the highest death rates were in the southwest. WY WI WV WA VA VT UT TX TN SD SC RI PA OR OK OH ND NC NY NM NJ NH NV NE MT MO MS MN MI MA MD ME LA KYKS IA INIL ID HI GA FL DC DE CT CO CA ARAZ AK AL 5.1-10.0 1.0-5.0 10.1-15.0 Deaths per 100,000
- 6. Figure 6 By 2010, the majority of states had death rates exceeding 5.0/100,000, and the death rate in two states exceeded 15.0/100,000. WY WI WV WA VA VT UT TX TN SD SC RI PA OR OK OH ND NC NY NM NJ NH NV NE MT MO MS MN MI MA MD ME LA KYKS IA INIL ID HI GA FL DC DE CT CO CA ARAZ AK AL 15.1+ SOURCE: Kaiser Family Foundation analysis of Centers for Disease Control and Prevention (CDC), National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database 5.1-10.0 1.0-5.0 10.1-15.0 Deaths per 100,000
- 7. Figure 7 In 2015, nearly a quarter of states had death rates exceeding 15.0/100,000, most of which were in Appalachia and New England. WY WI WV WA VA VT UT TX TN SD SC RI PA OR OK OH ND NC NY NM NJ NH NV NE MT MO MS MN MI MA MD ME LA KYKS IA INIL ID HI GA FL DC DE CT CO CA ARAZ AK AL SOURCE: Kaiser Family Foundation analysis of Centers for Disease Control and Prevention (CDC), National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database 15.1+ 5.1-10.0 1.0-5.0 10.1-15.0 Deaths per 100,000
- 8. Figure 8 Between 2005 and 2015, the increases in the opioid overdose death rate were particularly prominent in CT, DE, MS, NH, NY, OH, and WV. WY WI WV WA VA VT UT TX TN SD SC RI PA OR OK OH ND NC NY NM NJ NH NV NE MT MO MS MN MI MA MD ME LA KYKS IA INIL ID HI GA FL DC DE CT CO CA ARAZ AK AL 50-149% <50% 150-249% ≥250% Percent Increase in Death Rate SOURCE: Kaiser Family Foundation analysis of Centers for Disease Control and Prevention (CDC), National Center for Health Statistics. Multiple Cause of Death 1999-2015 on CDC WONDER Online Database
- 9. Figure 9 Medicaid covered 3 in 10 nonelderly adults with opioid addiction in 2015, nearly double the share covered in 2005. This increase was largely due to the ACA’s Medicaid expansion. SOURCE: Kaiser Family Foundation Analysis of 2015 National Survey on Drug Use and Health 17% 23% 30% 42% 37% 40% 8% 8% 10% 33% 32% 20% 2005 (1.4 million) 2010 (1.9 million) 2015 (2.3 million) Uninsured Other Private Medicaid
- 10. Figure 10 Medicaid coverage of nonelderly adults receiving outpatient treatment for opioid addiction grew from 27% in 2005 to 39% in 2015. 27% 31% 39% 34% 28% 36% 6% 12% 10% 34% 30% 15% 2005 (191,000) 2010 (380,000) 2015 (581,000) Uninsured Other Private Medicaid SOURCE: Kaiser Family Foundation Analysis of 2015 National Survey on Drug Use and Health
- 11. Figure 11 The share of nonelderly adults receiving inpatient treatment for opioid addiction who were covered by Medicaid doubled from 2005 to 2015. 26% 31% 52% 23% 21% 20% 4% 18% 14% 48% 30% 14% 2005 (146,000) 2010 (274,000) 2015 (299,000) Uninsured Other Private Medicaid SOURCE: Kaiser Family Foundation Analysis of 2015 National Survey on Drug Use and Health
- 12. Figure 12 • The BCRA includes 3 big changes to Medicaid that could impact states’ ability to address the opioid epidemic: – The enhanced federal financing for the Medicaid expansion population will be phased out. – Medicaid will be converted to a per capita cap allotment, limiting available funds to states. – Medicaid expansion plans will no longer be required to cover addiction treatment services, limiting enrollees’ access to care. • Although the BCRA allots $44.7 billion in grants over 9 years to provide addiction treatment, Medicaid spending on treatment is much higher. • Medicaid also facilitates access to other medical and behavioral health preventative and treatment services not covered by these grants.