The opioid epidemic continues to intensify, with over 2 million people addicted to prescription opioids and 591,000 people addicted to heroin in 2015. In addition, opioid overdose deaths nearly tripled between 2002 and 2015, surpassing 33,000 in 2015. Health care service utilization related to opioid use has also increased dramatically. Between 2000 and 2014, opioid-related inpatient stays increased 64% and opioid-related emergency department visits increased 99%.
Medicaid plays an important role in addressing the epidemic, providing coverage to over 650,000 non-elderly adults with opioid addiction and covering a range of treatment services. As of May 2017, 32 states have expanded Medicaid, with enhanced federal funding, to cover adults up to 138% of the federal poverty level ($16,643/year for an individual in 2017). By broadening coverage of adults, the Medicaid expansion reaches many low-income adults with opioid addiction who were previously ineligible for coverage and facilitates access to treatment.
However, many people with opioid addiction remain uninsured, in part because their states did not expand Medicaid. Of the 26 states with above average opioid overdose death rates, 8 have not expanded Medicaid as of May 2017. In total, nearly 441,000 non-elderly adults with opioid addiction were uninsured in 2015. That number may become substantially larger as a result of the GOP’s efforts to restructure the Medicaid program through the American Health Care Act, which may decrease eligibility and coverage, setting back states’ efforts to address the epidemic. The following series of graphics highlights the characteristics of uninsured nonelderly adults with opioid addiction.
1. 1 in 5 nonelderly adults with opioid addiction is uninsured.
2. Uninsured nonelderly adults with opioid addiction are predominantly white, male, and age 18-34.
3. Over 6 in 10 uninsured nonelderly adults with opioid addiction are working, but 58% have low incomes, including 37% below poverty.
4. Over 4 out of 5 nonelderly uninsured adults with opioid addiction do not have dependent children.
5. Over half of uninsured nonelderly adults with opioid addiction had a mental illness in the past year and over 1 in 5 had a serious mental illness, such as depression, bipolar disorder, or schizophrenia.
6. Among nonelderly adults with opioid addiction, those who were uninsured were less likely to have received treatment in the past year compared to those covered by Medicaid.