Medicaid Expansion Dramatically Increased Opioid Treatment Access, Study Finds
New research shows states expanding Medicaid after 2018 saw 21% increases in life-saving addiction medication prescriptions.
RALEIGH, NORTH CAROLINA — States that expanded Medicaid after 2018 saw dramatic increases in access to buprenorphine, a medication for treating opioid addiction, according to new research highlighting the healthcare program’s role in addressing the overdose crisis.
The study, which researchers will present next month, found that among all patients in the eight most recent Medicaid expansion states, the number of buprenorphine prescriptions increased by more than 21% between 2019 and 2023. The eight states that expanded Medicaid after 2018 were Idaho, Maine, Missouri, North Carolina, Oklahoma, South Dakota, Utah, and Virginia.
Most Dramatic Increases in Recent Expansion States
Maine, Oklahoma, and Virginia experienced the most significant boosts in buprenorphine access among the recent expansion states. The medication helps people overcome addiction to opioids including fentanyl and heroin by reducing cravings and withdrawal symptoms.
States that expanded Medicaid earlier also saw gains, but they were generally smaller. Among states that expanded Medicaid in 2018 or before, Kentucky, Vermont, and West Virginia experienced the largest increases in buprenorphine prescriptions.
Federal Policy Changes Enhanced Access
Stephen Crystal, director of the Center for Health Services Research at Rutgers University and one of the study’s authors, explained that buprenorphine became more accessible after 2018 as the federal government loosened various prescribing rules, including allowing prescribing via telehealth.
“Longer-term tracking shows that expansion, whether early or later, provides essential financial access and supports the growth of a provider network that improves population-level treatment rates,” Crystal told Stateline.
The research, published in February in JAMA Network Open, was conducted by researchers from Rutgers University and Indiana University using pharmacy claims data from retailers across the country.
Concerns About Future Access
The findings come as experts warn that potential Medicaid cuts could eliminate buprenorphine access for thousands of patients. The study examined prescription data for all patients, including those covered by Medicaid, other insurers, and the uninsured.
The research demonstrates how Medicaid expansion has served as a tool in addressing the opioid crisis by removing financial barriers to evidence-based addiction treatment. Buprenorphine is considered one of the most effective medications for opioid use disorder, helping patients maintain recovery while reducing the risk of overdose.
According to the researchers, the combination of Medicaid expansion and federal policy changes created a framework for increasing treatment access. The telehealth provisions, in particular, helped reach patients in rural and underserved areas where addiction treatment providers were scarce.
