Kyle Chapman

Date of Award


Degree Name

Healthcare Administration


College of Business

Type of Degree


Document Type

Research Paper

First Advisor

Alberto Coustasse


Introduction: The Medicaid expansion has insured millions of Americans since the passage of the Affordable Care Act in 2010. Among this newly insured population, many of the enrollees have been diagnosed with a substance abuse disorder. Patients who have a substance use disorder diagnosis typically have multiple conditions that are treated simultaneously. When these patients have to seek healthcare services they are often uninsured. Unfortunately, since the patients are uninsured, the most frequent healthcare access points have been through admissions to more expensive areas of healthcare delivery such as the emergency department and subsequent inpatient services. The goals of the Medicaid expansion not only included expanding coverage to the uninsured, but it also attempted to increase access to various forms of treatments while also decreasing the overall delivery of uncompensated care. Uncompensated care has been a persistent budgetary strain to healthcare providers across the nation.

Purpose of study: This research attempted to examine how the Medicaid expansion specifically impacted the SUD population’s access to treatments, whether uncompensated care utilization among this population was impacted, and whether the expanded coverage impacted the overall healthcare spending across the country.

Methodology: This research summarizes the relative peer review articles and their descriptions of the impact Medicaid expansion has had on the SUD population. An interview with a subject matter expert was also used in this research.

Results/Discussion: The examination of expanded treatment access to services like medication-assisted-treatment has shown notable promise. There was also progress observed in uncompensated care utilization rates for facilities delivering treatment to SUD patients, including community health centers and emergency departments. However, overall spending trends for the entire healthcare sector showed mixed results. Much of this research was dependent upon state adoption of the Medicaid expansion. At the time of this research, 41 states have accepted the terms of the Medicaid expansion, while 9 states have opted not to participate. The impact that non-expansion states have had on overall research numbers is a potential subject of further research.


Health services administration.

Health facilities -- Business management.

Substance abuse -- Treatment.