This edition examines the impact of Medicaid Expansion on prescription drug access, comparing prescription volume trends in 18 states that expanded Medicaid in 2014 with six non-expansion states. We look at overall prescription volume as well as three specific therapeutic classes of drugs: antidepressants, insulin, and bronchodilators.

Over the 10-year timeframe 2014-2023, we estimate that Medicaid Expansion led to nearly 1.2 billion additional prescriptions across the 18 states, representing a 56% increase in overall Medicaid prescription volume. In 2023, the pre-rebate cost per Medicaid prescription averaged $136, or over $1,600 annually per medication. Given the cost and the fact that over 80% of new Expansion enrollees were previously uninsured (and all had low income), these medications would largely have been inaccessible/unaffordable without Medicaid Expansion.