IMPORTANCEThe transition from prison to community is characterized by elevated morbidity and mortality, particularly owing to drug overdose. However, most formerly incarcerated adults with substance use disorders do not use any health care, including treatment for substance use disorders, during the initial months after incarceration. OBJECTIVE To evaluate whether a prerelease Medicaid enrollment assistance program is associated with increased health care use within 30 days after release from prison. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study included 16 307 adults aged 19 to 64 years with a history of substance use who were released from state prison between

Prescription drug formularies are an element of health insurance plan design that determine coverage and coinsurance rates for medications. Formularies are an important mechanism for healthcare cost containment that can increase the bargaining power of insurance companies in their negotiations with pharmaceutical manufacturers over the price of prescription drugs. The complexity of insurance plan design in settings such as the U.S. healthcare market and insurers' discretion over the elements of that design make it difficult to assess how changes in prescription drug coverage impact consumers. Evaluating changes in formulary design when such changes are endogenous choices of the insurer usually requires a structural approach as well as information on all other plan characteristics. While expanded coverage might increase prescription drug costs, spillovers from drug to non-drug spending raise the possibility that adding drugs to a formulary might decrease healthcare costs overall. For instance, Tamblyn et al. (2001) show that the rate of adverse health outcomes and emergency room visits increase among poor and elderly individuals following an increase in cost sharing for essential prescription drugs. Understanding how formulary design impacts healthcare costs and utilization is of great concern to countries like Canada, Mexico, Japan, Colombia, and the U.S. where prescription drug spending comprises more than 10% of total healthcare costs (OECD, 2020). Also of keen interest is how insurers' ability to respond to exogenous changes in formulary design impacts enrollees.

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