Publication Date: 
Tuesday, June 20, 2023

Coverage expansion for Medicaid improves access to care and health outcomes for people with substance use disorder (SUD). In spite of that evidence, as of May 2023, 10 states have failed to expand Medicaid funding to low-income adults as emergency enrollment protections established for COVID-19 end. This coverage gap in the non-expansion jurisdictions denies access to care to more than 1.9 million people living in Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. North Carolina and South Dakota have both approved expansion, but implementation was pending at the time the data were created. 

Outside of Medicaid expansion, the Medicaid Section 1115 waiver process offers a targeted mechanism for states to enhance their Medicaid offerings to better support people with SUD by directly supporting medications for opioid use disorder (MOUD) treatment during residency at an Institution for Mental Disease facility, coordination of MOUD treatment surrounding release from correctional facilities, and other care coordination. Section 1115 waivers may also impact how MOUD may be provided through interventions targeting social determinants of health (SDOH), including housing, nutrition, and transportation support. Traditionally, Section 1115 waivers have allowed states to experiment with new approaches in Medicaid that allow for more flexibility for enrollment and benefits.  

This dataset on is cross-sectional and displays key features of approved state Section 1115 waivers, particularly eligibility and benefit expansions that may increase access to services that benefit people with SUD, as well as states that have expanded their Medicaid coverage under the Affordable Care Act, across all 50 states and the District of Columbia as of April 20, 2023. The dataset builds upon the valuable existing research by the Kaiser Family Foundation tracking Medicaid Section 1115 waiver approvals. 

These data were created with support from the Foundation for Opioid Response Efforts (FORE).