Session: Medicaid's Expanding Role in Substance Use Disorder Treatment Under Health Reform: Implications for Treatment Coverage, Access, and Outcomes (Society for Social Work and Research 22nd Annual Conference - Achieving Equal Opportunity, Equity, and Justice)

As the United States' major public health insurance program for low-income citizens, Medicaid has become an increasingly important payer of SUD treatment over the past several decades. The number of states providing benefits for SUD treatment has expanded dramatically from just a handful of states in the 1980s to nearly every state in the country on the eve of the enactment of the Affordable Care Act (ACA) in 2010 (Buck, 2011; SAMHSA, 2005). From 1986 to 2005, Medicaid funding for SUD treatment more than doubled, and increased its share of total SUD treatment expenditures from 9% to 21% (Mark et al. 2007). What is more, Medicaid spending is expected to double again in the years ahead, from $5.2 billion in 2009 to $11.9 billion by 2020, making the program the largest payer of SUD treatment in the United States (Mark et al. 2014).

However, despite the program's expanding role in financing treatment, there is still only a modest body of research on Medicaid financing for SUD treatment, and its impact on access and outcomes for the vulnerable populations it services. Research focused on the ACA is especially important. While it is expected that the ACA's reforms to the Medicaid program will improve access to SUD treatment, empirical research is ongoing to assess its success in achieving these ends.

This symposium will contribute to knowledge in this area of study using nationally-representative data from the National Drug Abuse Treatment System Survey, a longitudinal study of SUD treatment programs in the United States, as well as public administrative data from South Carolina. The studies included in this symposium represent policy-relevant questions to increase understanding of Medicaid's impact on SUD treatment access and outcomes. Panelists will present research on (1) benefits for SUD treatment among the nation's 280 managed care plans; (2) the effects of Medicaid expansion on treatment access and financing; and (3) the role of broad local access to Medicaid-financed SUD treatment in reducing rates of emergency and acute care services. Taken together, the study findings suggest that despite the importance of Medicaid-financing SUD treatment, coverage varies substantially across Medicaid enrollees in the United States.