TY  - JOUR
AU  - Maclean, Johanna Catherine
AU  - Saloner, Brendan
TI  - The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 23342
PY  - 2017
Y2  - April 2017
DO  - 10.3386/w23342
UR  - http://www.nber.org/papers/w23342
L1  - http://www.nber.org/papers/w23342.pdf
N1  - Author contact info:
Johanna Catherine Maclean
Department of Economics
Temple University
Ritter Annex 869
Philadelphia, PA 19122
Tel: 215/204-0560
E-Mail: catherine.maclean@temple.edu

Brendan K. Saloner
Department of Health Policy
and Management
Johns Hopkins Bloomberg School
of Public Health
624 N. Broadway
Room 344
Baltimore, MD 21205
E-Mail: bsaloner@jhu.edu
AB  - We examine Medicaid expansion under the Affordable Care Act (ACA) on substance use disorder (SUD) treatment utilization and financing. We couple administrative data on admissions to specialty SUD treatment and prescriptions for medications used to treat SUDs with a differences-in-differences design, comparing expanding and non-expanding states. Post-expansion, admissions did not significantly change in expanding states relative to non-expanding states. We find that in expanding states Medicaid insurance and use of Medicaid to pay for treatment increased by 13.9 percentage points (71%) and 12.9 percentage points (75%) following the expansion. Post expansion, Medicaid-reimbursed prescriptions for medications used to treat SUDs in outpatient settings increased by 43% in expanding states relative to non-expanding states. We find no statistically significant evidence that Medicaid expansions affected fatal alcohol poisonings or drug-related overdoses. Overall, our findings imply that ACA Medicaid expansion had a large impact on the financing of SUD treatment and medication receipt. 
ER  -