Key result
The effect of ACA Medicaid expansions on drug-related mortality could not be isolated due to nonparallel preexpansion trends, fentanyl supply surges, and lack of statistical power.
Why the study?
Do ACA Medicaid expansions affect drug-related deaths?
Observational
Do ACA Medicaid expansions affect drug-related deaths?
Current data is insufficient to determine the link between ACA Medicaid expansions and opioid mortality due to confounding factors and lack of statistical power.
Current data cannot isolate ACA Medicaid expansion effects on drug mortality; leaves open any impact on opioid deaths amid confounding trends.
The Medicaid expansions made addiction treatment more accessible but they also made it less costly to obtain the prescription opioids that can trigger an addiction. We investigated the association between the Medicaid expansions and drug-related deaths. We add to the literature by explicitly accounting for the properties of illicit drug markets and by conducting a simulation-based power analysis to assess whether a plausible change in drug-related mortality could be detected with our data. We identify three main challenges in isolating the effect of the Medicaid expansions on drug-related mortality that cannot be sufficiently addressed with current data: (a) nonparallel preexpansion trends in drug-related mortality, (b) the contemporaneous surge in the supply of illicitly manufactured fentanyl, and (c) lack of statistical power. We argue that more comprehensive data are needed to answer this question.
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Abouk et al. (2020) conducted an observational in Opioid mortality. ACA Medicaid Expansions was evaluated on Drug-related mortality. The effect of ACA Medicaid expansions on drug-related mortality could not be isolated due to nonparallel preexpansion trends, fentanyl supply surges, and lack of statistical power.
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