AN ANALYSIS OF THE AFFORDABLE CARE ACT MEDICAID EXPANSION’S EFFECT ON DRUG OVERDOSE DEATHS

Abstract

The Patient Protection and Affordable Care Act was signed into law in 2010 as the largest reform to US healthcare since the introduction of Medicaid and Medicare, to extend higher quality medical care coverage to a greater number of American citizens. The Medicaid Expansion portion of the act was initially compulsory for states and mandated that they extend eligibility to individuals and families at and below 138% of the poverty line or risk losing federal funding. However, a Supreme Court ruling made the expansion voluntary, and some states elected not to expand, creating a natural experiment to evaluate the success of the Medicaid Expansion. Previous research and empirical analyses have analyzed coverage effects, utilization of health services, self-assessed health, and mortality rates. This thesis uses the crude rate of overdose deaths as the measured variable in response to the surge in overdose deaths. Data comes from the CDC injury center and KFF foundation. Difference-in-Difference models are used to compare Expansion states to non-Expansion states and separate the effects by age group. This thesis found a positive effect of 5.67 crude rate points associated with the Medicaid expansion. Ages 25-54 were the most impacted, and the effect of the Expansion grew from 2014-2018.