Blaming Medicaid for the Opioid Crisis: How the Easy Answer Can Be Wrong
By Aaron E. Carroll and Austin Frakt
The theory has gained such prominence that a United States senator is investigating it.
“Medicaid expansion may be fueling the opioid epidemic in communities across the country,” Senator Ron Johnson, Republican of Wisconsin, wrote recently.
Some conservative opponents of the Affordable Care Act have been passing around the same theory for months. It’s a politically explosive (and convenient) argument, but is it true? Substantial evidence suggests the answer is no, but let’s give it a fair hearing.
Some data seems to support this connection, and the idea has a certain logic. Coverage from Medicaid — or any kind of health insurance for that matter — plays a role in access to prescription opioids, just as it does for access to many other types of health care.
We know from earlier analyses that Medicaid enrollees tend to be prescribed opioids more frequently than people with other kinds of coverage. But that could be because of other factors also related to insurance. It’s important to remember that people who go on Medicaid are sicker than those with other forms of coverage, so they may have more pain that warrants opioids.
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