The opioid epidemic, involving both prescription pain relievers and heroin, is affecting the entire nation, but not in the same way or to the same extent in every location. Having previously published white papers on national trends in the opioid epidemic and the impact of the epidemic on the healthcare system, FAIR Health now turns its attention in this third white paper in the series to regional variations in the effects of the opioid crisis. A national, independent, nonprofit organization dedicated to transparency in healthcare costs and health insurance information, FAIR Health analyzed data from its database of billions of privately billed healthcare claims to study the opioid crisis in rural and urban settings and in the nation’s five most populous cities and the states in which they are situated during the recent ten-year period 2007 to 2016.

For more than two decades, an epidemic of obesity in the United States has been cited as contributing to rising rates of type 2 diabetes, and, alarmingly, both conditions have been increasing among the nation’s youth. A study of five years of healthcare insurance claims records by FAIR Health, a national, independent, nonprofit organization dedicated to transparency in healthcare costs and health insurance information, confirms this concerning trend.

The state of Connecticut has made impressive gains in insuring its residents since the passage of the Affordable Care Act (ACA): More than 700,000 individuals have enrolled in public or private coverage through the Access Health CT health insurance marketplace since 2013, lowering the state’s uninsured rate from 12.3 percent to 3.8 percent between 2013 and 2016.1 With this commendable progress in increasing the number of residents with insurance coverage, there is an urgent need to advance health insurance literacy (HIL) among the newly insured. HIL is defined as “the degree to which individuals have the knowledge, ability, and confidence to find and evaluate information about health plans, select the best plan for their own (or their family’s) financial and health circumstances, and use the plan once enrolled.”2 Barriers to achieving adequate levels of HIL disproportionately affect the newly insured, minority groups and those with lower incomes and educational levels. In 2015, FAIR Health received generous funding from the Connecticut Health Foundation to launch the Engage Health CT initiative, which is intended to promote HIL through the development and dissemination of a mobile app that offered education on health insurance terms and concepts and geographically-specific cost estimates for medical and dental services. FAIR Health undertook qualitative research through focus groups intended to generate a more robust understanding of the state of HIL in Connecticut.

The current epidemic of opioid abuse, involving both prescription pain relievers and heroin, is having a major impact on the US healthcare sector. In its white paper issued in July 2016, The Opioid Crisis among the Privately Insured, FAIR Health reported on the epidemic’s impact on healthcare services as evidenced by an increase of 3,203 percent in claim lines with an opioid dependence diagnosis from 2007 to 2014. In this second white paper, FAIR Health examines the increasing healthcare costs and demand for specific services attributable to the epidemic.