The Affordable Care Act (ACA) may have prompted state Medicaid programs to expand addiction treatment benefits in alternative benefit plans, according to a study published in the August issue of Health Affairs

Christina M. Andrews, Ph.D., from the University of South Carolina in Columbia, and colleagues surveyed Medicaid programs in all 50 states and the District of Columbia to assess their addiction treatment benefits and utilization controls in standard and alternative benefit plans in 2014 and 2017 when plans were subject to ACA parity requirements.

Medicaid benefits

The researchers found that the number of state plans that provided benefits for residential treatment and opioid use disorder medications increased substantially over the study period.

The number of state plans that provided benefits for residential treatment and opioid use disorder medications increased substantially. States imposing annual service limits on outpatient addiction treatment decreased by over 50 percent. 

There was more than a 50% decrease in states imposing annual service limits on outpatient addiction treatment. In addition, fewer states require preauthorization for services. The greatest reductions for preauthorizations were for medications treating opioid use disorder.

"The ACA may have prompted state Medicaid programs to expand addiction treatment benefits and reduce utilization controls in alternative benefit plans," the authors write. "This trend was also observed among standard Medicaid plans not subject to ACA parity laws, which suggests a potential spillover effect."