[Political Calculations] Nicholas Eberstadt recently raised an interesting question regarding the role of Medicaid, the United States' welfare program that provides free health insurance for Americans with low incomes, when he commented on how it may very well have directly contributed to the nation's rising problem with opioid addiction.It occurred to us that we have the ability to determine whether Medicaid is contributing to the nation's growing opioid epidemic by taking advantage of a natural experiment made possible by the Affordable Care Act. More popularly known as "Obamacare", the primary means by which the ACA has expanded health insurance coverage in the U.S. has been through the expansion of eligibility in the U.S.' Medicaid welfare program, where the threshold for eligibility was raised from 100% of the federal poverty limit to 138% of the federal poverty limit in states that agreed to expand their Medicaid programs.
But, not all states agreed to expand their Medicaid program when the Affordable Care Act went into effect on 1 January 2014. From that time through 2015, 28 states and the District of Columbia had chosen to participate in the Affordable Care Act's expansion of eligibility for Medicaid, while 22 others opted to not do so during those years.