On the Health Affairs Blog, a Vanderbilt econ professor and a former Obama administration official tackle the Obamacare-opioid connection, arguing that the Medicaid expansion did not in fact contribute to the worsening opioid crisis. It’s an interesting article, but I simply don’t understand how their main evidence supports their thesis. They confirm that drug mortality rates were converging between expansion and non-expansion states prior to 2010 and began diverging subsequently, with an additional jump upward in 2015 after the expansions came into effect:
And they confirm that places with lower uninsurance rates had larger jumps upward in overdoses:
The uninsurance rate is, they confirm, negatively correlated with increases in drug-related mortality. One of the two authors was a Obama Administration spokesperson for expanding coverage a few years ago, so I would say this is an interesting finding. Yes, since the x axis is the uninsurance rate in 2013, this graph suggests that insurance expansions prior to 2014 were also associated with increased overdoses from 2010 to 2015- the Medicaid expansion itself wasn’t uniquely responsible, insurance in general was. But recall that even as early as 2010 the expansions were highly politicized issues, with liberal state governments determined to expand coverage and conservative state governments determined not to. It seems silly to contend that changes in the four years between the law’s passage and its full implementation should be excluded from consideration of its effects.