Changes in State Technical Assistance Priorities and Block Grant Funds for Addiction After ACA Implementation

Area of Science:

• Public Health
• Health Services Research
• Substance Abuse Treatment

Background:

• The Affordable Care Act (ACA) expanded health insurance coverage, impacting addiction treatment services in the US.
• Understanding how states allocate resources and provide technical assistance is crucial for effective public health strategies.

Purpose of the Study:

• To evaluate state-level technical assistance and block grant funding for addiction treatment, prevention, and outreach post-ACA expansion.
• To identify changes in resource allocation and technical assistance priorities among Single State Agencies.

Main Methods:

• Utilized two waves of survey data from the National Drug Abuse Treatment System Survey (2014 and 2017).
• Data collected from Single State Agencies across the United States.

Main Results:

• Increased provision of technical assistance for cross-sector collaboration and workforce development.
• Shift in funding from outpatient to residential addiction treatment services.
• Limited change in resources allocated for opioid use disorder medications; disparities noted between Medicaid expansion and non-expansion states.

Conclusions:

• The ACA facilitated reallocation of funds towards residential services, which may have less insurance coverage.
• Insufficient allocation of block grant funds towards effective opioid medications is a public health concern, especially in non-Medicaid expansion states.
• State-level differences in technical assistance and funding highlight the impact of Medicaid expansion on addiction treatment resource allocation.