The Affordable Care Act In The Heart Of The Opioid Crisis: Evidence From West Virginia

Abstract

West Virginia is the epicenter of a national opioid crisis. We examine trends in treatment for opioid use disorder (OUD) among individuals enrolled in the West Virginia Medicaid expansion program under the Affordable Care Act using 2014-2016 claims data. Expanding Medicaid could provide services to populations that may previously have had limited access to OUD treatment. We thus sought to understand trends over time in OUD diagnosis and treatment, especially with medications. About 5.5% of all enrollees were diagnosed with OUD per year, and the monthly prevalence of OUD diagnoses nearly tripled during this three-year period. The ratio of individuals filling buprenorphine to the number diagnosed with OUD was around one-third in early 2014, increasing to more than 75% by late 2016. Mean annual duration of filled buprenorphine increased from 161 days in 2014 to 185 days in 2016, and most individuals filling buprenorphine also received counseling and drug testing during the study period. The growing use of medication treatment for OUD in the West Virginia Medicaid expansion provides an opportunity to reduce overdose deaths.

The opioid crisis and the 2020 US election: crossroads for a national epidemic

“…8 In West Virginia, the state with the highest rate of deaths from opioid-involved overdose as of 2018, 9 buprenorphine prescriptions for patients with opioid use disorder increased by an estimated 42% between 2014, when Medicaid was first expanded in the state, and 2016. 10 Treatments with buprenorphine and methadone were associated with 38% and 59% decreases in opioid-related mortality, respectively, according to one study in Massachusetts; all forms of MAT should be made accessible. 11 US President Donald Trump has repeatedly called for the repeal of the ACA, which would roll back Medicaid expansion.…”

Federal and State Action Needed to End the Infectious Complications of Illicit Drug Use in the United States: IDSA and HIVMA’s Advocacy Agenda

“…Federal support for the Medicaid expansion must continue and the 14 states that have not expanded Medicaid should be incentivized to do so [ 19 ]. Recent studies have shown that expansion of health care services, mostly via Medicaid expansion, increased utilization of MOUD [ 3 , 41 , 42 ]. Expanding access to health coverage is necessary to prevent and treat the infection, underlying SUD, and improve overall mortality and quality of life as evidenced by studies finding an association between enrollment in an Affordable Care Act Qualified Health Plan and improved outcomes for people with HIV [ 43 ].…”

Telegenetics in Rural Appalachia: Implementation Experiences and Barriers to Effective Clinical Care for Populations Experiencing Health Disparity

“…Data indicates that West Virginia consistently ranks among states with the highest percentage of people experiencing mental health problems and encompass depression, anxiety, schizophrenia, and bipolar disorder (14). Genetic and genomic testing are performed for different purposes, such as identifying carriers, predicting a disease onset in presymptomatic individuals, or con rming a diagnosis, and such information may have notable psychological effects, such as generating anxiety and depression (15).…”