Monday, January 22, 2018

Senate Republicans blame expansion of Medicaid for increased opioid deaths, but research debunks claim

"Republicans in the U.S. Senate are trying out an interesting scapegoating tactic when it comes to the escalation of the nation’s opioid crisis. They are pointing the finger of blame at Medicaid, the federal-state program that provides health care coverage to millions of low-income Americans," Quinn Libson reports for Route Fifty.

The root of their argument: The expansion of Medicaid under Obamacare has increased patients' access to prescription medications, including opioids; some of those patients abuse their prescription opioids and some sell them on the black market. So says a report released Jan. 17 by Sen. Ron Johnson of Wisconsin. Johnson, who chairs the Senate Homeland Security and Governmental Affairs Committee, held a hearing that day with the goal of revealing the "unintended consequences" of Medicaid. In July 2017, Johnson wrote a letter making the same claim to the Department of Health and Human Services' inspector general, saying: "Because opioids are so available and inexpensive through Medicaid, it appears that the program has created a perverse incentive for people to use opioids, sell them for large profits, and stay hooked."

But the facts don't bear out that argument, Quinn reports. Andrew Goodman-Bacon, an assistant professor of economics at Vanderbilt University, and Emma Sandoe, a health-policy Ph.D. student at Harvard University, analyzed Johnson's claim. According to their findings, published in Health Affairs, the claim is not credible for three main reasons: "First, trends in opioid deaths nationally and by Medicaid expansion status predate the ACA. Second, counties with the largest coverage gains actually experienced smaller increases in drug-related mortality than counties with smaller coverage gains. Third, the fact that Medicaid recipients fill more opioid prescriptions than non-recipients largely reflects greater levels of disability and chronic illness in the populations that Medicaid serves. While we do not reject the possibility that public policy has played a role in our current prescription abuse crisis, on balance we find little evidence to support the idea that Medicaid caused or worsened the epidemic."

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