IDEAS home Printed from https://ideas.repec.org/p/fip/fedbcq/93991.html
   My bibliography  Save this paper

Did the Medicaid Expansion Crowd Out Other Payment Sources for Medications for Opioid Use Disorder? Evidence from Rhode Island

Author

Listed:
  • Mary A. Burke
  • Riley Sullivan

Abstract

Using information from the all-payer claims database for Rhode Island covering more than three-quarters of health insurance enrollees in the state from April 2011 through May 2019, this paper offers new measures of the association between the Medicaid expansion and the rate of receipt of buprenorphine and methadone for opioid use disorder (OUD). These robust measures adjust for the extent to which new Medicaid payments for these medications that started in 2014 crowded out payments from either non-Medicaid insurance or from non-insurance subsidies for the treatment of opioid abuse. We find that crowding out was nontrivial but incomplete for either buprenorphine or methadone, such that the Medicaid expansion in Rhode Island appears to have enabled many patients to access medications for OUD for the first time. These findings offer support for the expansion of Medicaid in states that have not already done so.

Suggested Citation

  • Mary A. Burke & Riley Sullivan, 2022. "Did the Medicaid Expansion Crowd Out Other Payment Sources for Medications for Opioid Use Disorder? Evidence from Rhode Island," Current Policy Perspectives 93991, Federal Reserve Bank of Boston.
    • Handle: RePEc:fip:fedbcq:93991
    as

    Download full text from publisher

    File URL: https://www.bostonfed.org/publications/current-policy-perspectives/2022/did-the-medicaid-expansion-crowd-out-other-payment-sources-for-medications-for-opioid-use-disorder
    File Function: Summary
    Download Restriction: no
    File URL: https://www.bostonfed.org/-/media/Documents/Workingpapers/PDF/2022/cpp20220414.pdf
    File Function: Full text
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Mary A. Burke & Katherine Grace Carman & Riley Sullivan & Hefei Wen & James Frank Wharam & Hao Yu, 2021. "Did the Affordable Care Act Affect Access to Medications for Opioid Use Disorder among the Already Insured? Evidence from the Rhode Island All-payer Claims Database," Working Papers 21-17, Federal Reserve Bank of Boston.
    2. Kosali Simon & Aparna Soni & John Cawley, 2016. "The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the 2014 ACA Medicaid Expansions," NBER Working Papers 22265, National Bureau of Economic Research, Inc.
    3. Akosa Antwi, Yaa & Moriya, Asako S. & Simon, Kosali I., 2015. "Access to health insurance and the use of inpatient medical care: Evidence from the Affordable Care Act young adult mandate," Journal of Health Economics, Elsevier, vol. 39(C), pages 171-187.
    4. Mary A. Burke & Riley Sullivan, 2020. "Medication-assisted Treatment for Opioid Use Disorder in Rhode Island: Who Gets Treatment, and Does Treatment Improve Health Outcomes?," New England Public Policy Center Research Report 20-3, Federal Reserve Bank of Boston.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mary A. Burke & Katherine Grace Carman & Riley Sullivan & Hefei Wen & James Frank Wharam & Hao Yu, 2021. "Did the Affordable Care Act Affect Access to Medications for Opioid Use Disorder among the Already Insured? Evidence from the Rhode Island All-payer Claims Database," Working Papers 21-17, Federal Reserve Bank of Boston.
    2. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2018. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health," Southern Economic Journal, John Wiley & Sons, vol. 84(3), pages 660-691, January.
    3. Courtemanche, Charles & Friedson, Andrew & Koller, Andrew P. & Rees, Daniel I., 2019. "The affordable care act and ambulance response times," Journal of Health Economics, Elsevier, vol. 67(C).
    4. Bradley Heim & Ithai Lurie & Kosali Simon, 2015. "The Impact of the Affordable Care Act Young Adult Provision on Labor Market Outcomes: Evidence from Tax Data," Tax Policy and the Economy, University of Chicago Press, vol. 29(1), pages 133-157.
    5. Gopi Shah Goda & Monica Farid & Jay Bhattacharya, 2016. "The Incidence of Mandated Health Insurance: Evidence from the Affordable Care Act Dependent Care Mandate," NBER Working Papers 21846, National Bureau of Economic Research, Inc.
    6. Zhao, Weimin, 2019. "Does health insurance promote people's consumption? New evidence from China," China Economic Review, Elsevier, vol. 53(C), pages 65-86.
    7. Bradley Heim & Ithai Lurie & Kosali Simon, 2018. "Did the Affordable Care Act Young Adult Provision Affect Labor Market Outcomes? Analysis Using Tax Data," ILR Review, Cornell University, ILR School, vol. 71(5), pages 1154-1178, October.
    8. Heeju Sohn, 2017. "Racial and Ethnic Disparities in Health Insurance Coverage: Dynamics of Gaining and Losing Coverage Over the Life-Course," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 36(2), pages 181-201, April.
    9. Barış K. Yörük & Yiran Han, 2024. "Age-based health insurance coverage policies and mental health," Journal of Population Economics, Springer;European Society for Population Economics, vol. 37(2), pages 1-26, June.
    10. Milovanska-Farrington, Stefani & Farrington, Stephen, 2019. "The effect of the cost of obstetric care on antenatal and postnatal healthcare utilization: Evidence from Armenia," Research in Economics, Elsevier, vol. 73(1), pages 72-84.
    11. Gregory Colman & Dhaval Dave, 2018. "It'S About Time: Effects Of The Affordable Care Act Dependent Coverage Mandate On Time Use," Contemporary Economic Policy, Western Economic Association International, vol. 36(1), pages 44-58, January.
    12. David J G Slusky, 2017. "Significant Placebo Results in Difference-in-Differences Analysis: The Case of the ACA’s Parental Mandate," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 43(4), pages 580-603, September.
    13. Pinka Chatterji & Xiangshi Liu & Barış K. Yörük, 2019. "The effects of the 2010 Affordable Care Act dependent care provision on family structure and public program participation among young adults," Review of Economics of the Household, Springer, vol. 17(4), pages 1133-1161, December.
    14. Genevieve E O'Connor, 2016. "Investigating the significance of insurance and income on health service utilization across generational cohorts," Journal of Financial Services Marketing, Palgrave Macmillan, vol. 21(1), pages 19-33, March.
    15. Pinka Chatterji & Xiangshi Liu & Barış K. Yörük, 2022. "Health insurance and the boomerang generation: Did the 2010 ACA dependent care provision affect geographic mobility and living arrangements among young adults?," Contemporary Economic Policy, Western Economic Association International, vol. 40(2), pages 243-262, April.
    16. Andrey Aistov & Ekaterina Aleksandrova & Christopher J. Gerry, 2021. "Voluntary private health insurance, health-related behaviours and health outcomes: evidence from Russia," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(2), pages 281-309, March.
    17. Johanna Catherine Maclean & Michael F. Pesko & Steven C. Hill, 2017. "The Effect of Insurance Expansions on Smoking Cessation Medication Prescriptions: Evidence from ACA Medicaid Expansions," NBER Working Papers 23450, National Bureau of Economic Research, Inc.
    18. Michael DiNardi, 2017. "Affordable Care Act Medicaid Expansions and the Impact on Nurses," 2017 Papers pdi509, Job Market Papers.
    19. Yörük Barış K., 2017. "Health Insurance Coverage and Risky Health Behaviors among Young Adults," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 17(3), pages 1-21, July.
    20. Maclean, Johanna Catherine & Tello-Trillo, Sebastian & Webber, Douglas, 2023. "Losing insurance and psychiatric hospitalizations," Journal of Economic Behavior & Organization, Elsevier, vol. 205(C), pages 508-527.

    More about this item

    Keywords

    opiod use disorder; Medicaid expansion; buprenorphine; methadone; crowding out; Rhode Island; all-payer claims database;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:fip:fedbcq:93991. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Spozio (email available below). General contact details of provider: https://edirc.repec.org/data/frbbous.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.