Yesterday, the U.S. Senate barely passed the reconciliation bill that, among other things, will make cuts to Medicaid and other healthcare spending and lead to 11 million people losing their health insurance coverage, the vast majority of these in Medicaid. As I wrote in my previous post, Medicaid is a major payer for substance use treatment in the United States.

According to one analysis, Medicaid made up 93 percent of claims for substance use treatment, whereas private insurance covered 6 percent. Prior studies have also found that people enrolled in Medicaid have higher risks of overdosing than people who are not on Medicaid (twice as high as the general population and four times as high as those on private insurance), because people on Medicaid are low-income and have a more precarious life. That said, people who need substance use treatment who are on Medicaid still aren’t getting it—about 55 percent of people who met the definition of a SUD and were in Medicaid were not enrolled in treatment.

Medicaid is a program where funding responsibilities are shared by the federal and state governments, with the federal government taking on the lion's share. This bill would create challenges to state funding by reducing federal contributions and limiting how much states can increase provider taxes to fund such aid. But for individuals, these cuts will primarily come in two ways: through increased reporting........

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