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Enhancing Medicaid to Expand Addiction Treatment Access

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Opioids are essential to the practice of medicine.  However, they are also addictive and carry significant risk of overdose. The unprecedented level of prescribing in the U.S. continues to unintentionally cause cases of addiction

Medicaid is a safety net insurer covering over 70 million Americans that has become the U.S.’s largest source of funding for the treatment of opioid addiction. However, some states have not expanded Medicaid as allowed by the Affordable Care Act, and/or have limited coverage of opioid use disorder treatment within traditional Medicaid programs.



  • The 2010 Affordable Care Act expanded Medicaid and implemented other legal changes that increased access to addiction treatment and medication for opioid addiction.

  • Following the Affordable Care Act, states imposing annual service limits on outpatient addiction treatment decreased by more than half.

  • The 2018 SUPPORT for Patients and Communities Act augmented Medicaid’s ability to reimburse residential addiction treatment.

  • This Act also required state Medicaid programs to have prescription verification programs in place at pharmacies for opioid refills and to monitor concurrent prescribing of opioids.


Expanding Medicaid and improving its addiction-related benefits can increase access to treatments with strong evidence of effectiveness for opioid addiction.

Key Policy Evidence:

  • One study found that states that expanded Medicaid under the Affordable Care Act increased the number of individuals who received prescriptions for the addiction medication buprenorphine
  • The same study revealed that Medicaid expansion did not increase prescriptions for opioid pain medication. 
  • A number of states do not cover methadone maintenance under Medicaid. This treatment has been proven to reduce illicit drug use, overdose, needle sharing, crime, and unemployment among opioid-addicted individuals.
  • Opioid-addicted adults who are covered by Medicaid are twice as likely to receive treatment as are opioid-addicted adults who lack insurance.