Penn researchers correlate Medicaid expansions with slower climb in drug-related deaths

Researchers at the Perelman School of Medicine conducted a study finding that state expansions in Medicaid did not lead to increases in opiate-related deaths — contrary to what some critics of Medicaid have posited. 

Led by medical professor Atheendar Venkataramani and Paula Chatterjee, a post-doctoral researcher, the study linked the 2001-2002 Medicaid expansions across Arizona, Maine, and New York with slower rises in overdose mortality rates compared to states whose Medicaid programs were not similarly expanded.

The study, which examined mortality rates from the time of expansion until 2008, was published online in the Journal of General Internal Medicine. The researchers used state-level data from the Centers for Disease Control and Prevention to track overdose mortality trends in the three states with the Medicaid expansions compared to trends in other states. Although these three states had two fewer overdose deaths per 100,000 people in 1999 than the non-expansion states in 1999, this figure became seven fewer overdose deaths per 100,000 people in 2008.  

Within the early expansion states, the study suggests that Medicaid expansion corresponds to nearly 20 percent lower drug overdose deaths than if expansion had not taken place, Penn Medicine News reported.

Medicaid expanded coverage to all childless adults across the three states who were under the federal poverty line, as well as to a portion of those above the poverty line but with dependent children. Since then, the number of deaths related to drug overdoses has risen dramatically nationwide. It roughly doubled during the period of the study and has roughly doubled again since 2008 to over 72,000 American drug overdose deaths in 2017, as reported in the National Institute on Drug Abuse. 

“These findings suggest that Medicaid expansions were unlikely to have contributed to the subsequent rise in drug overdose deaths, and may even have been protective,” Venkataramani told Penn Medicine. He added that he hoped the study would convince policymakers that state expansions of Medicaid, including those under the Affordable Care Act, would not make drug abuse more prevalent.

Although the study did not look into the reasons for this correlation, the researchers also noted to Penn Medicine News that Medicaid expansions could increase access to substance abuse treatment and improve people's mental health and financial security.

The opioid crisis has not spared Philadelphia — more than 1200 drug-related overdose deaths occurred in the city in 2017, according to Philadelphia Department of Public Health Data. Earlier this year, members of the student-run Medical Emergency Response Team began to carry Narcan, a nasal spray that can jolt overdosed opiate users back to life, on their shifts.