Blaming Medicaid for the Opioid Crisis: How the Easy Answer Can Be Wrong

The New York Times – The theory has gained such prominence that a United States senator is investigating it.

“Medicaid expansion may be fueling the opioid epidemic in communities across the country,” Senator Ron Johnson, Republican of Wisconsin, wrote recently.

Some conservative opponents of the Affordable Care Act have been passing around the same theory for months. It’s a politically explosive (and convenient) argument, but is it true? Substantial evidence suggests the answer is no, but let’s give it a fair hearing.

Some data seems to support this connection, and the idea has a certain logic. Coverage from Medicaid — or any kind of health insurance for that matter — plays a role in access to prescription opioids, just as it does for access to many other types of health care.

We know from earlier analyses that Medicaid enrollees tend to be prescribed opioids more frequently than people with other kinds of coverage. But that could be because of other factors also related to insurance. It’s important to remember that people who go on Medicaid are sicker than those with other forms of coverage, so they may have more pain that warrants opioids.

It is also true that the 31 states that expanded Medicaid experienced a larger increase in drug overdoses between 2013 and 2015 than states that did not. As Mr. Johnson wrote, “These data appear to point to a larger problem.”

But this is a weak foundation on which to base a conclusion that Medicaid is driving the opioid epidemic. Responding to these facts when they were first noted, a Department of Health and Human Services statement said, “Correlation does not necessarily prove causation, and additional research is required before any conclusions can be made.”

Read more at The New York Times.

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