As the United States grapples with a persistent overdose crisis, new research from Rutgers Health reveals that Medicaid expansions implemented between 2017 and 2023 have “sharply increased” access to critical medications for opioid use disorder (OUD).
The study, published in JAMA Network Open, comes at a high-stakes moment for New Jersey and the nation, as policymakers debate the future of healthcare funding amid proposed federal cuts.
The Rutgers Center for Health Services Research found that expanded Medicaid coverage led to significant population-level increases in the use of buprenorphine, a gold-standard medication used to stabilize patients and reduce cravings.
The timing is critical: CDC data shows that more than 80,000 people in the U.S. died from opioid overdoses between October 2023 and September 2024. Because individuals with OUD are disproportionately represented in low-income brackets, Medicaid has become the primary engine for delivering recovery services.
While earlier studies on the initial 2014 expansions showed mixed results, Rutgers researchers noted that the “current era” of treatment is different. Recent federal and state reforms have removed long-standing barriers, creating a more flexible environment where Medicaid expansion can have a broader impact. These reforms include:
- Telehealth Expansion: Allowing patients to consult with specialists remotely.
- Prescriber Diversity: Authorizing more types of clinicians to prescribe OUD medications.
- Outpatient Authorization: Streamlining the process for obtaining medication outside of highly restricted clinics.
“In the current era… Medicaid expansion is not just helpful, but essential,” Stephen Crystal, study co-author and director of the Rutgers Center for Health Services Research.
The study’s findings directly challenge the logic of proposed federal Medicaid cuts under H.R. 1. Lead author Nicole Siegal warned that the financial sustainability of these expansions is under threat just as they are proving their widespread effectiveness.
“These results could be incredibly important for public policymakers and state governments wrestling with the Medicaid cuts,” Siegal noted. “This study shows that these expansions are having the kind of widespread impact that earlier research suggested might not be possible.”
The Rutgers team, including co-authors Jennifer Miles and Hillary Samples, will present their findings at the 2026 AcademyHealth Annual Research Meeting in Seattle this May.
As New Jersey continues to leverage its status as a Medicaid-expansion state to combat the addiction crisis, this research provides the empirical “ammunition” needed for state leaders to defend the program as a cornerstone of public health infrastructure.
