Medicaid Expansion

Medicaid expansion will not end Maine’s opioid epidemic

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Dedicating more public funds to a government program is not a measure of successful policy. It never has been, and it never will be. Success is measured by outcomes, not dollars.

James Myall, a policy analyst at the Maine Center for Economic Policy (MECEP), recently released a blog post on MECEP’s website that asserts expanding Medicaid eligibility under the Affordable Care Act (ACA), also known as ObamaCare, would “tackle” Maine’s opioid crisis. Maine voters will choose whether to expand Medicaid at the ballot box in November.

In the post, Myall criticizes Maine for the state’s 21 percent decline, a little less than $3 million, in funding for anti-addiction medications between 2011 and 2016 while states across the country increased spending in this area by 155 percent on average. While this is true, the Maine DHHS’ overall spending on substance abuse treatment and prevention increased by a greater amount over the same span. Regardless, spending is not a measure of success.

As it relates to the opioid epidemic, Medicaid expansion is intended to offer treatment to previously uninsured segments of the population facing drug addiction, giving them access to services they would not otherwise have. However, the data doesn’t show that expanded eligibility, or the enhanced levels of funding, are positively impacting states that experience troubles with opioid abuse.

This is because, as noted twice above, spending money is not a measure of success.

The five states identified by the Centers for Disease Control and Prevention (CDC) as having the highest rates of opioid overdose deaths – West Virginia, New Hampshire, Kentucky, Ohio and Rhode Island – have all expanded Medicaid under the ACA and continue to experience rising rates of opioid overdose deaths.

Additionally, all five states have enhanced funding for anti-addiction medication between 2011 and 2016, with Kentucky, Ohio, and West Virginia increasing their individual state expenditures in this area by 326, 467 and 431 percent respectively.

What are the outcomes of expanded eligibility and wheelbarrows full of additional funding?

According to the CDC, between 2014 and 2015, Ohio had a 21 percent increase in opioid overdose deaths. Between 2015 and 2016, opioid overdose deaths increased by 36 percent in the state.

Similar outcomes are seen in Rhode Island and Kentucky. Between 2013 and 2014, Kentucky had a 4.2 percent increase in opioid deaths and Rhode Island saw a 4.5 percent increase. In 2016, Kentucky experienced 12.5 percent increase in opioid deaths and Rhode Island saw 10 percent growth.

The CDC has cited studies that show Medicaid recipients are prescribed opioids at rates two times higher than those with private insurance. A CDC state-level study of Washington also found that Medicaid enrollees were nearly six times more likely to die from opioids than someone not enrolled in the program.

It’s time to start asking if Medicaid is the problem and not the solution. While this data does not constitute enough evidence to conclude that Medicaid is completely harmful or ineffective, it significantly undermines the claims of those on the left who say that accepting expansion funds would noticeably improve Maine’s capacity to address the opioid crisis.

If these funds would help end Maine’s opioid epidemic as expansion proponents claim, why does the problem continue to get worse in expansion states?

There is no silver bullet to solving the opioid epidemic in Maine, or any other state, and expanding Medicaid has yet to be proven a reliable solution.

About Jacob Posik

Jacob Posik, of Turner, is a policy analyst for the Maine Heritage Policy Center. He can be reached at jposik@mainepolicy.org.

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