Kenneth A Feder1, Ramin Mojtabai2, Noa Krawczyk2, Andrea S Young3, Marc Kealhofer4, Kayla N Tormohlen2, Rosa M Crum4. 1. Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 North Broadway, Baltimore, MD 21205, United States. Electronic address: kfeder1@jhu.edu. 2. Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 North Broadway, Baltimore, MD 21205, United States. 3. Johns Hopkins Medicine, Department of Psychiatry, 733 N Broadway, Baltimore, MD 21205, United States. 4. Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 624 North Broadway, Baltimore, MD 21205, United States.
Abstract
PURPOSE: This short communication examines the impact of the Patient Protection and Affordable Care Act (PPACA) on insurance coverage and substance use treatment access among persons with opioid use disorders. METHODS: Data came from the 2010-2015 National Surveys on Drug Use and Health. Among persons with heroin and opioid pain-reliever use disorders, measures of insurance coverage and treatment access were compared before and after the implementation of major PPACA provisions that expanded access to insurance in 2014. RESULTS: The prevalence of uninsured persons among those with heroin use disorders declined dramatically following PPACA implementation (OR 0.59, 95% CI 0.39-0.89), largely due to an increase in the prevalence of Medicaid coverage (OR 1.96, 95% CI 1.21-3.18). There was no evidence of an increase in the prevalence of treatment, but among persons who received treatment, there was an increase in the proportion whose treatment was paid for by insurance (OR 3.75, 95% CI 2.13-3.18). By contrast, there was no evidence the uninsured rate declined among persons with pain-reliever use disorders. CONCLUSIONS: The PPACA Medicaid expansion increased insurance coverage among persons with heroin use disorders, and likely plays an essential role in protecting the health and financial security of this high-risk group. More research is needed on the relationship between insurance acquisition and utilization of substance use treatment.
PURPOSE: This short communication examines the impact of the Patient Protection and Affordable Care Act (PPACA) on insurance coverage and substance use treatment access among persons with opioid use disorders. METHODS: Data came from the 2010-2015 National Surveys on Drug Use and Health. Among persons with heroin and opioid pain-reliever use disorders, measures of insurance coverage and treatment access were compared before and after the implementation of major PPACA provisions that expanded access to insurance in 2014. RESULTS: The prevalence of uninsured persons among those with heroin use disorders declined dramatically following PPACA implementation (OR 0.59, 95% CI 0.39-0.89), largely due to an increase in the prevalence of Medicaid coverage (OR 1.96, 95% CI 1.21-3.18). There was no evidence of an increase in the prevalence of treatment, but among persons who received treatment, there was an increase in the proportion whose treatment was paid for by insurance (OR 3.75, 95% CI 2.13-3.18). By contrast, there was no evidence the uninsured rate declined among persons with pain-reliever use disorders. CONCLUSIONS: The PPACA Medicaid expansion increased insurance coverage among persons with heroin use disorders, and likely plays an essential role in protecting the health and financial security of this high-risk group. More research is needed on the relationship between insurance acquisition and utilization of substance use treatment.
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