NATIONAL BUREAU OF ECONOMIC RESEARCH
NATIONAL BUREAU OF ECONOMIC RESEARCH

The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act

Johanna Catherine Maclean, Brendan Saloner

NBER Working Paper No. 23342
Issued in April 2017, Revised in September 2017
NBER Program(s):Health Care, Health Economics

We examine Medicaid expansion under the Affordable Care Act (ACA) on substance use disorder (SUD) treatment utilization and financing. We couple administrative data on admissions to specialty SUD treatment and prescriptions for medications used to treat SUDs with a differences-in-differences design, comparing expanding and non-expanding states. Post-expansion, admissions did not significantly change in expanding states relative to non-expanding states. We find that in expanding states Medicaid insurance and use of Medicaid to pay for treatment increased by 13.9 percentage points (71%) and 12.9 percentage points (75%) following the expansion. Post expansion, Medicaid-reimbursed prescriptions for medications used to treat SUDs in outpatient settings increased by 43% in expanding states relative to non-expanding states. We find no statistically significant evidence that Medicaid expansions affected fatal alcohol poisonings or drug-related overdoses. Overall, our findings imply that ACA Medicaid expansion had a large impact on the financing of SUD treatment and medication receipt.

download in pdf format
   (618 K)

email paper

The NBER Bulletin on Aging and Health provides summaries of publications like this.  You can sign up to receive the NBER Bulletin on Aging and Health by email.

Machine-readable bibliographic record - MARC, RIS, BibTeX

Document Object Identifier (DOI): 10.3386/w23342

Users who downloaded this paper also downloaded* these:
Glaeser w10166 Reinventing Boston: 1640-2003
Auerbach, Charles, Coile, Gale, Goldman, Lee, Lucas, Orszag, Sheiner, Tysinger, Weil, Wolfers, and Wong w23329 How the Growing Gap in Life Expectancy May Affect Retirement Benefits and Reforms
Baker, Gruber, and Milligan w11832 Universal Childcare, Maternal Labor Supply, and Family Well-Being
Bettinger, Long, Oreopoulos, and Sanbonmatsu w15361 The Role of Simplification and Information in College Decisions: Results from the H&R Block FAFSA Experiment
Rosen, Ghosh, Shelton Pape, Coca Perraillon, Bondarenko, Messer, Raghunathan, Stewart, and Cutler w23290 Strengthening National Data to Better Measure What We Are Buying in Health Care: Reconciling National Health Expenditures with Detailed Survey Data
 
Publications
Activities
Meetings
NBER Videos
Themes
Data
People
About

National Bureau of Economic Research, 1050 Massachusetts Ave., Cambridge, MA 02138; 617-868-3900; email: info@nber.org

Contact Us