Journal of General Internal Medicine

, Volume 34, Issue 1, pp 23–25 | Cite as

Early Medicaid Expansions and Drug Overdose Mortality in the USA: a Quasi-experimental Analysis

  • Atheendar S. VenkataramaniEmail author
  • Paula Chatterjee
Concise Research Reports


The widespread availability of prescription and illicit opioids is thought to be a key driver of the rise in drug overdose mortality in the USA.1 The role of health insurance in increasing access to prescription opioids has thus emerged as a key policy issue. Policymakers and commentators have raised concerns that Medicaid expansions—such as those implemented as part of the Affordable Care Act (ACA)—may have caused the rise in drug overdose mortality, citing more deaths from drug overdose in states that expanded Medicaid versus those that did not.2

Assessing whether insurance expansions helped cause the rise in drug overdose mortality is challenging in the midst of a national crisis. The availability of opioids1 and drug overdose mortality rates3 were already increasing prior to the ACA. In addition, the crisis has evolved like an epidemic and assessing root causes is difficult during periods of accelerating growth in disease rates.

We examined the effect of Medicaid...


drug overdose mortality opioid crisis Medicaid USA quasi-experimental 


Funding Information

No specific funding was received for this study. ASV reports salary support from the National Institutes of Health (Mentored Career Development Award, grant K23MH106362).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • Atheendar S. Venkataramani
    • 1
    • 2
    Email author
  • Paula Chatterjee
    • 2
    • 3
  1. 1.Department of Medical Ethics and Health Policy, Perelman School of Medicine University of PennsylvaniaPhiladelphiaUSA
  2. 2.Leonard Davis Institute of Health EconomicsUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Division of General Internal Medicine, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA

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