Medicaid benefits for addiction treatment expanded after implementation of the Affordable Care Act
Open accessAbstract
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.
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The ACA increased the number of insurance choices available.
“including an increase in insurance choices (Abraham et al., 2017; Andrews et al., 2018; Feder et al., 2017).”
From Healthcare utilization of individuals with substance use disorders following Affordable Care Act implementation in a California healthcare system (2020) · cites this paper as Andrews et al., 2018
The Study Results (Alternative Benefit Coverage; page unavailable) report an increase in the number of states offering an alternative Medicaid benefit plan. The paper does not establish that individuals had more insurance plans to choose from; its finding concerns plan availability across states and addiction-treatment benefits. (LLM, conf=0.73)
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- Authors
- Andrews, C. M., Grogan, C. M., Smith, B. T., Abraham, A. J., Pollack, H. A., Humphreys, K., Westlake, M. A., & Friedmann, P. D.
- Affiliations
- University of South Carolina (US)
- University of Chicago (US)
- University of Georgia (US)
- VA Palo Alto Health Care System (US)
- Baystate Health (US)
- ORCID
- Venue
- Health Affairs
- Publisher
- Health Affairs Publishing, LLC
- Published
- 2018-08
- Volume
- 37
- Issue
- 8
- Pages
- 1216-1222
- ISSN
- 0278-2715 (ISSN-L)
- 1544-5208
- PMC
- PMC6501794
- OpenAlex
- W2887386573
- Cited by
- 54
- References
- 20
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 5 · 2023: 5 · 2022: 7 · 2021: 7 · 2020: 14 · 2019: 11
- FWCI
- 12.16
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Health Affairs (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Agency for Healthcare Research and Quality (T32HS000084)
- National Institute on Drug Abuse (R01DA034634)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- Medicaid, addiction treatment, Affordable Care Act, parity law, medication-assisted treatment, residential treatment, utilization control, prior authorization, state Medicaid programs, spillover effects, health insurance coverage
- MeSH terms
- Medicaid, United States, Insurance Coverage, Substance-Related Disorders, Patient Protection and Affordable Care Act
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