
A concerning report from the Department of Health and Human Services reveals that over half a million Medicaid recipients with opioid use disorder were denied medication-assisted treatment in 2021, constituting one-third of affected individuals. Alarming racial and age disparities were also highlighted, with Black and young patients receiving treatments at significantly lower rates. Medicaid, covering 40% of nonelderly adults with opioid use disorder, has a unique opportunity to bridge these gaps, but the report warns of potential access restrictions after the federal coverage mandate ends in 2025. Urgent action and concrete policies are needed to address these disparities and ensure equitable opioid addiction treatment.
In a disconcerting revelation, a report from the inspector general of the Department of Health and Human Services has exposed a grave issue: more than half a million Medicaid recipients diagnosed with opioid use disorder were denied medication-assisted treatment in 2021. This alarming figure represents one-third of all Medicaid beneficiaries grappling with opioid addiction. The report also sheds light on glaring disparities in treatment rates, particularly concerning age and race. Shockingly, Black and young individuals received treatments at significantly lower rates compared to their white and middle-aged counterparts.
The report emphasized that Medicaid, covering nearly 40 percent of nonelderly adults with opioid use disorder, possesses a unique opportunity to bridge these gaps. However, it warned that once the federal government’s mandatory coverage period concludes in September 2025, some states might revert to restricting access, exacerbating the crisis.
Despite the effectiveness of medications like methadone, buprenorphine, and naltrexone in curbing cravings and preventing fatalities, the stigma around their usage and the scarcity of willing providers hinder patients’ access. Adding to the problem, awareness about Medicaid covering these treatments only became widespread in October 2020.
The disparities in medication uptake varied widely among states, with Rhode Island and Vermont leading at almost 90 percent, while states like Illinois and Mississippi languished below 40 percent. Medicaid expansion and state policies significantly influenced these variations, impacting aspects such as reimbursement for telehealth services and the prescribing authority of nurse practitioners and physician assistants.
Furthermore, racial disparities were glaring: over 70 percent of white patients received medication, compared to a paltry 53 percent among Black patients, despite a more significant increase in overdose deaths within the Black community. Age also played a role, with individuals under 19 receiving treatment at a mere 11 percent rate, contrasting starkly with the 70 percent rate for those aged 19 to 44.
The inspector general’s report outlined specific steps for the Centers for Medicare & Medicaid Services, urging them to break down barriers and reach marginalized groups. However, experts like Dr. Ayana Jordan criticized these recommendations as insufficient, calling for more concrete policies, such as incentives for healthcare providers in underserved areas, collaborations with community organizations, and addressing medication shortages in pharmacies catering to communities of color. Urgent action is imperative, as lives hang in the balance, underscoring the need for comprehensive, equitable, and accessible opioid addiction treatment.