Senator Ron Johnson held a public hearing and issued an accompanying report yesterday on unintended consequences of Medicaid expansion on the opioid crisis. You can read discussions of the event ranging from Vox’s condescending dismissal, to ThinkProgress’s righteous indignation, to Newsweek and the LA Times‘s tendentious rebuttals, to a fairly sympathetic writeup from USA Today, and a standard he-said she-said from the Washington Post.
Since I believe, I think without much delusion, that I started this ball rolling last March and have kept it rolling pretty well since then, I obviously don’t have a totally dispassionate view. Even so, I recognize there are multiple, fairly strong lines of argument against Medicaid playing a significant causal role in the divergence between expansion and non-expansion states. However, the basic fact is that there is a very large divergence to explain.
None of the critical write-ups of the issue have included these basic statistics as a factor to explain or overcome. The Vox write-up by German Lopez calls the correlation between Medicaid expansion status & greater increases in overdoses since Obamacare passage a “Republican claim,”but the association itself is a simple fact. The question is if that correlation is due to the ACA or something else.
Look, I’m just a pseudonymous coward, and as I’ve said before, I’m not a public health expert or an expert in addiction and recovery or pharmaceuticals. I very well may be wrong in arguing that the Medicaid expansion had a large, causal effect on overdoses. However, the failure of a single academic public health expert to make a good faith effort to grapple with the existence of a very large divergence as a plausible effect of the ACA expansion and recognize it as an important empirical puzzle rather than an easily dismissed partisan claim is deeply disturbing to me. The ability of almost every single high-status news organization similarly to treat this as just “another case of those wacky Republicans grasping at straws” rather than a serious hypothesis with multiple competing explanations is equally depressing. The anti-empirical turn in America is real.