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Report
The Medicaid Expansion and the Uptake of Medication-assisted Treatment for Opioid Use Disorder: Evidence from the Rhode Island All-payer Claims Database, 2012–2018
This article uses the all-payer claims database for the state of Rhode Island to assess recent progress in the state toward the goal of expanding access to medication-assisted treatment (MAT) for opioid use disorder (OUD). The analysis highlights the role played by the Affordable Care Act (ACA) and the associated Medicaid expansion in furthering that goal. Using measures that account for changes in health insurance enrollment, we find that the MAT rate per 100,000 enrollees in Rhode Island effectively doubled between 2012 and 2018, while the prevalence of OUD in the sample also doubled over ...
Report
Did the Medicaid Expansion Crowd Out Other Payment Sources for Medications for Opioid Use Disorder? Evidence from Rhode Island
Using information from the all-payer claims database for Rhode Island covering more than three-quarters of health insurance enrollees in the state from April 2011 through May 2019, this paper offers new measures of the association between the Medicaid expansion and the rate of receipt of buprenorphine and methadone for opioid use disorder (OUD). These robust measures adjust for the extent to which new Medicaid payments for these medications that started in 2014 crowded out payments from either non-Medicaid insurance or from non-insurance subsidies for the treatment of opioid abuse. We find ...
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Reintegrating the ex-offender population in the U.S. labor market: lessons from the CORI Reform in Massachusetts
Policymakers have proposed and enacted policies that seek to limit the negative consequences that a criminal record imposes on ex-offenders, their families, and society at large. Some states have changed how criminal records are accessed and governed in the interest of removing unduly burdensome barriers to employment for some ex-offenders. Between 2010 and 2012, Massachusetts enacted the Criminal Offender Record Information (CORI) Reform, changing access guidelines for criminal records and preventing employers from inquiring about criminal history on an initial application for employment. ...
Report
The Impact of Felony Larceny Thresholds on Crime in New England
Criminal justice reform has been a high-priority policy area in New England and the nation in recent years. States are generally seeking legislation that would help reintegrate ex-offenders into society while still prioritizing the welfare of all members of the public and the achievement of fiscal goals. The research findings presented in this report indicate that raising felony larceny thresholds—that is, increasing the dollar value of stolen property at or above which a larceny offense may be charged in court as a felony rather than a misdemeanor, a policy adopted by three New England ...
Report
Medication-assisted Treatment for Opioid Use Disorder in Rhode Island: Who Gets Treatment, and Does Treatment Improve Health Outcomes?
Since the early 2000s Rhode Island has been among the states hardest hit by the opioid crisis. In response, the state has made it a priority to expand access to medication-assisted treatment (MAT) for opioid use disorder (OUD), which refers to the use of the FDA-approved medications methadone, buprenorphine, and/or naltrexone in conjunction with behavioral therapy. MAT is strongly supported by scientific evidence and endorsed by US public health officials and yet fails to reach many OUD patients. Using administrative data covering medical treatments and selected health outcomes for more than ...
Report
Can Treatment with Medications for Opioid Use Disorder Improve Employment Prospects? Evidence from Rhode Island Medicaid Enrollees
The nation’s long-standing crisis of opioid abuse intensified during the COVID-19 pandemic, with opioid-related deaths rising to nearly 81,000 in 2021, an increase of more than 60 percent from just two years earlier. Also during the pandemic, the labor force participation rate in the United States fell precipitously, and as of September 2022 it remained depressed by more than a full percentage point relative to its February 2020 level despite record numbers of job openings in 2021 and 2022. The unfortunate confluence of labor shortages and record-setting opioid mortality highlights the need ...
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The criminal population in New England: records, convictions, and barriers to employment
The portion of the U.S. population with a criminal record has been receiving mounting attention in recent years. While there is a significant amount of data about the criminal population under supervision, there is very limited linked data identifying how most individuals move through the criminal justice system. By analyzing multiple national and state data sources, this report aims to identify the size of the New England population with a criminal record and to describe the broad demographic characteristics of this population. The report illustrates that the size of the population in the ...
Report
Why is state and local government capital spending lower in the New England states than in other U.S. states?
This report explores several hypotheses as to why state and local governments in New England have been spending less on capital investment than the national average, on a normalized basis. Census data show that state and local capital spending in all six New England states was well below the national average between 2000 and 2012, whether measured on a per capita basis, as a share of personal income, or as a share of state and local government spending. To explore why this is so, this report considers how capital spending has changed over time, how capital spending differs by state and across ...
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Exploring causes of and responses to the opioid epidemic in New England
The opioid epidemic remains rampant in New England, where, from 2015 through 2017, more than 10,000 people died from opioid overdoses. In 2017, each of the six states experienced an overdose-death rate that was greater than the national average. Beyond causing a high number of deaths, the opioid epidemic is costing New England productive workers. People with the most severe problems stemming from opioid-use disorder tend to be in the 25?44 age group, but no one is immune. The epidemic affects people of every type?all ages and all races, men and women, residents of rural areas and of urban ...
Report
The fiscal impact of the opioid epidemic in the New England states
The rise in the abuse of?and addiction to?opioids and the rapid increase in the number of fatal overdoses in recent years have made the opioid epidemic a priority for local, state, and federal policymakers. Understanding the epidemic?s direct fiscal impact is key to acknowledging its scope and magnitude. While opioid abuse has many direct and indirect fiscal costs, few studies quantify them. This report assembles available data on the impact of opioid epidemic on criminal justice, treatment, and related health expenditures in the New England states. The research finds that state governments ...