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Health Aff (Millwood). 2018 Aug;37(8):1216-1222. doi: 10.1377/hlthaff.2018.0272.

Medicaid Benefits For Addiction Treatment Expanded After Implementation Of The Affordable Care Act.

Author information

1
Christina M. Andrews ( candrews@mailbox.sc.edu ) is an assistant professor in the College of Social Work, University of South Carolina, in Columbia.
2
Colleen M. Grogan is a professor in the School of Social Service Administration, University of Chicago, in Illinois.
3
Bikki Tran Smith is a PhD student in the School of Social Service Administration, University of Chicago.
4
Amanda J. Abraham is an assistant professor in the School of Public and International Affairs, University of Georgia, in Athens.
5
Harold A. Pollack is the Helen Ross Professor in the School of Social Service Administration, University of Chicago.
6
Keith Humphreys is a professor of psychiatry and behavioral sciences in the Department of Psychiatry, Stanford School of Medicine, and a senior research career scientist at the Veterans Affairs Palo Alto Health Care System, both in California.
7
Melissa A. Westlake is a PhD student in College of Social Work, University of South Carolina.
8
Peter D. Friedmann is chief research officer for academic affairs at Baystate Health, in Springfield, Massachusetts.

Abstract

The Affordable Care Act (ACA) established a minimum standard of insurance benefits for addiction treatment and expanded federal parity regulations to selected Medicaid benefit plans, which required state Medicaid programs to make changes to their addiction treatment benefits. We surveyed Medicaid programs in all fifty states and the District of Columbia regarding their addiction treatment benefits and utilization controls in standard and alternative benefit plans in 2014 and 2017, when plans were subject to ACA parity requirements. The number of state plans that provided benefits for residential treatment and opioid use disorder medications increased substantially. States imposing annual service limits on outpatient addiction treatment decreased by over 50 percent. Fewer states required preauthorization for services, with the largest reductions for medications treating opioid use disorder. The ACA may have prompted state Medicaid programs to expand addiction treatment benefits and reduce utilization controls in alternative benefit plans. This trend was also observed among standard Medicaid plans not subject to ACA parity laws, which suggests a potential spillover effect.

KEYWORDS:

Health Reform; Medicaid; Mental Health/Substance Abuse

PMID:
30080460
DOI:
10.1377/hlthaff.2018.0272

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