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The ACA Has Reduced Opioid-Related Deaths Among Young Adults

New research suggests the provision allowing people to stay on their parents' health insurance has meant that more young people are getting treatment and help.
Prescription opioid sales in the U.S. spiked on the dark Web after it became harder for patients to obtain prescriptions for them.

Each percentage point increase in the number of 19- to 25-year-olds covered by insurance is associated with a reduction in opioid-related deaths of nearly 20 percent, per new research.

President Donald Trump's administration has called combating America's opioid epidemic a top priority. More recently, the administration renewed its multi-pronged campaign to overturn the Affordable Care Act, a.k.a. Obamacare.

New research suggests that those two policies are at odds with each other.

A new study finds that one particularly popular provision of the ACA—allowing parents to keep their children on family health-insurance plans through age 25—significantly reduced the opioid-related mortality rate among young adults.

Specifically, each percentage point increase in the number of 19- to 25-year-olds covered by insurance is associated with a reduction in opioid-related deaths of nearly 20 percent.

"The results indicate that recent coverage expansions blunted the crisis," concludes Boston College economist Gal Wettstein. His study is published in the journal Health Economics.

Wettstein begins by noting there has been something of a debate over whether health insurance has played a positive or negative role in the opioid crisis. Obviously, access to doctors increases the likelihood one can get treatment and care. On the other hand, most opioid addictions begin with doctor-prescribed pain medications. Because of this, some observers have speculated that less access to physicians may head off some dependencies before they begin.

Wettstein unearthed the actual impact of health access by focusing on opioid-related deaths among 19- to 25-year-olds following the ACA's implementation. He looked at the years 2011 to 2016, noting the share of the young-adult population in each state that was not insured in 2009, and thus could benefit the most from the increase in coverage.

Not surprisingly, he found mortality rates rose over that period, but the increase was significantly smaller in states where more young adults gained access to insurance. What's more, this trend increased over time.

"I estimate that insurance coverage significantly decreased the risk of opioid-related deaths among young adults, with every percentage point of coverage reducing deaths by 19.8 percent," Wettstein writes. This suggests that "accessing addiction and mental-health treatment, alternative pain treatment, economic security, and general physical health included in health insurance could reduce opioid mortality.

It stands to reason that those trends could reverse if the young-adult insurance provisions are gutted along with the rest of the ACA. Wettstein doesn't address that possibility, but rather speculates about the impact of potential future laws and regulations that will ensure still more Americans have health insurance.

"Although further expansions of coverage are not likely to completely prevent opioid deaths," he concludes, "they may go some way toward reducing them."