New Study Debunks Claims That Medicaid Expansion Helped Cause The Opioid Crisis


We’ve all heard the common sense line that “correlation does not imply causation.” If you fall asleep before the sun goes down, that doesn’t mean that you caused the sundown. The same principle applies to the Republican narratives blaming the opioid crisis on the Medicaid expansion that’s funded by 2010’s The Affordable Care Act (Obamacare).

In September, The New York Times reported that Sen. Ron Johnson (R-WI) was leading an investigation into the cause of the drug epidemic ravaging through the country. Their months long process lead the Senate Homeland Security and Governmental Affairs Committee finally releasing a report and conducting ensuing hearings suggesting it was the public health insurance program for the working class that was to blame.

New findings suggests this couldn’t be further from the truth.

According to a new report from Vox, the Republican narrative is that it was Obamacare — through its incentivising for states to expand medicaid to “include everyone at or below 138 percent of the federal poverty level (around $16,750 a year for an individual)” — that made access to gateway opioid painkillers significantly worse.

They says it’s enabling the people the liberty of going to the doctor that’s fuelling these addictive vices and their sale on the black market, and that it’s all a ruse that’s being subsidised right now by the United States government. It’d sound like quite a conspiracy from the likes of InfoWars… if their own site didn’t slightly debunk it back in August 2017. No, instead you’ll find these claims being pushed by not only red members of the Senate, but their so-called credible voices like The Daily Wire, Fox News, Louder With Crowder, go down the list of sites who did less work than Alex Jones.

Consider that a new study published in JAMA Network Open put this new conservative narrative to the test — and they failed. Miserably, in fact, to the point the results showed that the Medicaid expansion “may help combat the opioid crisis by expanding or maintaining access to addiction treatment”. The same kind of treatment programs, which the study found Medicaid, “crucial” for treating the opioid epidemic, that that even InfoWars columnist Julie Fidler admitted would have been “drastically cut” under Trump’s failed campaign to “repeal and replace” Obamacare back in 2017.

In his report, researchers Brendan Saloner and his fellow colleagues for the Johns Hopkins Bloomberg School of Public Health and the Substance Abuse and Mental Health Services Administration examined the prescription refilling trends of painkillers across three states that expanded Medicaid versus two that didn’t. This was possibly to give Medicaid-sceptics less room to cry bias and emphasise the effects of the government policy, though that’s just an assumption of their approach.

The results, in any case, conclude that the prescription rates between all states were not “significantly changed” whether the state adopted or rejected the government expansion. They also analysed drugs such as buprenorphine (otherwise brand named as Suboxone), which was described by the outlet as the “gold standard treatment for opioid addiction”, was significantly higher compared to states without the Medicaid expansion. These account for recent trends and didn’t analysis results years during/before the expansion.

“We looked directly at the fills for prescriptions, and we don’t really find evidence that bears out [Johnson’s] story,” Saloner told outlets like Vox and The L.A. Times. “[The research] rebuts the idea that Medicaid expansion was this pathway for a big increase in people filling prescriptions for opioid pain medication, but there was a big increase in people getting addiction treatment where they were prescribed buprenorphine-naloxone.”

This treatment is only available through a doctor’s prescription and carries the hefty price of nearly $200 per month. Saloner argues that yes, people will pay for their drugs with the government if they have the liberty to do so. He also argues this is a “shift rather than an increase”. Those druggies, who already pay out of pocket or via private insurance, just change their provider.

“Prescriptions [for opioid painkillers] did fall overall. If you look at the expansion and non-expansion states, they’re trending down,” Saloner contnued. “Medicaid expansion doesn’t break that trend. You don’t see them falling less rapidly in the expansion than the non-expansion states.”

It’s a similar argument regarding the legalisation of most-all drugs. If you have the ability to take heroin, the people who would do so legally are also the people turning to the black market. Your normally person is less likely to take this action, especially when opioids have a less appealing face in the public eye compared to a more enticing, safer product like cannabis.

They’re supported by other studies, such as Health Affairs Organisation, which recently conclude similar findings arguing that Obamacare, alongside its Medicaid expansion “may have prompted state Medicaid programs to expand addiction treatment benefits and reduce utilization controls in alternative benefit plans.”

It’s a sad state of affairs when the fringe conspiracy blogs, known for their pushing of the #Pizzagate story and whether Sandy Hook was a hoax, are closer to the truth on this topic than those in mainstream conservative politics. Medicaid is no perfect angel that can do no wrong. Remember that it’s still the American healthcare system where medical bankruptcy is a reality and the drugs are overpriced compared to its Canadian neighbours.

But it’s a step in the right direction for cure to the crisis. “There’s [always] room for improvement,” Saloner cautioned Vox journalist German Lopez. “There’s pockets of innovation happening. We’re nowhere near a full-scale national model for how to do this effectively.”

Thanks for reading!

Bailey T. Steen is a journalist, designer and film critic residing in the heart of Victoria, Australia. He’s also a proud Putin Puppet on occasion.

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