Medicaid expansion has allowed millions with substance use disorders to get health coverage, access treatment

Substance Use Disorders (SUDs) have become a serious challenge in America. Abuse of prescription painkillers now ranks second as the nation’s most widespread illegal drug problem, according to the NC Department of Health and Human Services.

Today, the Center on Budget and Policy Priorities (CBPP), released a report concluding that the Affordable Care Act (ACA) expansion of Medicaid to low-income adults has allowed millions of people with SUDs to get health coverage and access to SUD treatment services. This same conclusion was reached by the U.S. Surgeon General last year when it released its comprehensive report ‘Facing Addiction in America’.

Opioids—prescription and illicit—are the main driver of drug overdose deaths. In the U.S., opioids were involved in 33,091 deaths in 2015, and opioid overdoses have quadrupled since 1999. A significant increase in drug overdose death rates from 2014 to 2015 was primarily seen in the Northeast and South. North Carolina was one of the states in which drug overdose death rates had a statistically significant increase (14.5 percent) between 2014 and 2015.

Last year a report mapped out the top 25 worst cities in the U.S for opioid abuse and North Carolina showed up 4 times on that list. The worst city in America for opioid abuse according to the study was Wilmington. Hickory was the 5th, followed by Jacksonville at 12th and Fayetteville at 18th.

In order to continue to serve millions of Americans suffering from SUDs, CBPP recommends that states:

  • Reject imposing conditions on Medicaid such as work requirements, premiums and cost-sharing, and drug testing. According to CBPP, “these conditions would erect barriers to eligibility and coverage and would result in fewer low-income people being covered and receiving the health care they need.”
  • Continue state flexibility and innovation to improve SUD service delivery. Examples include: expanding coverage for SUD services, using CMS’ Innovation Accelerator Program.
  • Consider Medicaid health homes and Accountable Care Organizations (ACOs) targeted to people with behavioral health needs. States receive an enhanced federal matching rate for health home services provided during the first two years of their health home programs. ACOs are designed to more effectively serve high-cost, high-need people with chronic conditions, mental illness, or SUDs.

Last month, North Carolina’s Attorney General Josh Stein, legislators and local law enforcement held a news conference to unveil the “STOP Act”, legislation focused on improving rules to prescribe and dispense opioid drugs and funds for treating opioid abusers and helping them get clean. Based on the statistics above, it is clear that cuts to Medicaid would hurt states’ ability to provide substance use treatment to those in need.

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