Survey Highlights Differences In Medicaid Coverage For Substance Use Treatment And Opioid Use Disorder Medications

Health Aff (Millwood). 2016 Dec 1;35(12):2289-2296. doi: 10.1377/hlthaff.2016.0623.

Abstract

The Affordable Care Act requires state Medicaid programs to cover substance use disorder treatment for their Medicaid expansion population but allows states to decide which individual services are reimbursable. To examine how states have defined substance use disorder benefit packages, we used data from 2013-14 that we collected as part of an ongoing nationwide survey of state Medicaid programs. Our findings highlight important state-level differences in coverage for substance use disorder treatment and opioid use disorder medications across the United States. Many states did not cover all levels of care required for effective substance use disorder treatment or medications required for effective opioid use disorder treatment as defined by American Society of Addiction Medicine criteria, which could result in lack of access to needed services for low-income populations.

Keywords: Access To Care; Disparities; Health Reform; Medicaid; Mental Health/Substance Abuse.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Analgesics, Opioid / therapeutic use*
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Insurance Coverage / statistics & numerical data*
  • Medicaid / statistics & numerical data*
  • Opioid-Related Disorders / drug therapy*
  • Patient Protection and Affordable Care Act
  • Surveys and Questionnaires
  • United States

Substances

  • Analgesics, Opioid