Substance Abuse Prevention and Treatment block grant still needed, despite Medicaid expansion

Substance Abuse Block Grants will continue to be significant for uninsured, low-income individuals to pay for specialty substance use treatment, despite expected increases in Medicaid enrollment, according to recent findings.

To assess the potential shift from public funds to Medicaid coverage for substance use treatment and its impact on vulnerable populations, Albert Woodward, PhD, MBA, of SAMHSA’s Center for Behavioral Health Statistics and Quality, analyzed Treatment Episode Data Set (TEDS) data from 2012, the most recent available TEDS data.

“As the type of health insurance coverage and employment status changes very little from year to year in TEDS, the situation in 2014 can be expected to be represented by that in 2012,” Woodward wrote.

There were 1.7 million TEDS admissions aged 12 years and older in 2012.

The majority of substance abuse treatment admissions aged 18 to 64 years with known insurance status were unemployed or not in the labor force (72.9%).

Of these, 58.3% did not have health insurance, 25.7% had Medicaid coverage and 16% had some other type of health insurance.

“The 58.3% who were uninsured and unemployed or not in the labor force would likely be covered by public funds, which could include [Substance Abuse Block Grants] funding, as well as Medicaid for those newly enrolled under the Affordable Care Act,” according to Woodward.

However, it is unlikely that Medicaid could absorb the entire proportion of individuals uninsured and unemployed or not in the work force, Woodward said.

“Under the Affordable Care Act, some of the treatment that has been covered by the [Substance Abuse Block Grants] is likely to be covered by the expansion of Medicaid. Despite the expected increase in Medicaid enrollment, the [Substance Abuse Block Grants] will still be important in paying for specialty substance abuse treatment for uninsured, low-income individuals,” Woodward concluded.

Reference:

Woodward, A. The CBHSQ report: the substance abuse prevention and treatment block grant is still important even with the expansion of Medicaid. Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality.