The Effect of the Affordable Care Act on Opioid Overdose Mortality

The opioid epidemic is an ongoing health crisis in the United States, claiming the lives of thousands over the past two decades. In 2014, provisions of the Affordable Care Act expanding Medicaid officially came in effect, extending healthcare to millions of people in the United States. However, Medicaid expansion was optional for states, so some states greatly expanded healthcare to low-income people while others did not. People in expansion states gained more affordable access to prescription drugs and treatment centers, making opioids easier to obtain and addictions more affordable to treat. This makes the effect of the Affordable Care Act on the opioid epidemic ambiguous, since it could either help or worsen the crisis, depending on if easier access to opioids or treatment has a larger effect on overdoses. In this paper, I use a difference-in-differences approach using state-level data from 2008 to 2019 to compare Opioid overdose death rates between expansion states and non-expansion states. I find significant evidence that Medicaid expansion is correlated with an increase in Opioid overdose deaths.