Increased receipt of buprenorphine treatment for opioid use disorder (OUD) under Medicaid could improve outcomes for residents of expansion states residents for relapse, retention in OUD treatment, involvement in the justice system, health, and mortality. Under the Affordable Care Act, many low-income adults with OUD in the 32 states (including DC) that expanded Medicaid gained access to buprenorphine, which is covered in all state Medicaid programs. In contrast, many low-income uninsured adults with OUD in nonexpansion states still lack access to affordable treatment. The 176.4 percent increase in buprenorphine prescriptions between the fourth quarter of 2013 and the fourth quarter of 2016, along with the 70.1 percent increase in buprenorphine prescriptions per enrollee in Medicaid expansion states, suggest a large-scale expansion in access to effective treatment. Yet persistent capacity shortages and other barriers to accessing treatment raise the question of whether treatment is meeting demand, even in those states.
Originally posted May 22, 2017, this brief was reposted June 9, 2017, with updated estimates for the third quarter of 2016 and new estimates for the fourth quarter of 2016.