Health Plan Disenrollment Linked To 51% Higher Mortality Risk For Patients Receiving OUD Medications

March 20, 2026

Health plan disenrollment was associated with higher mortality rates among people who started medication treatment for opioid use disorder (OUD). All-cause mortality rates were 51% higher, and overdose mortality rates were 56% higher among those who experienced health plan disenrollment.

The researchers analyzed outcomes for 20,011 people age 16 and older who had started OUD treatment with buprenorphine or naltrexone at three integrated health insurance and care delivery systems in two states. The cohort included individuals with both private and public insurance who started treatment between January 1, 2012, and December 31, 2021. Participants were followed for up to two years, through December 31, 2022.

Of the 20,011 participants, 34.7% (6,948 people) experienced disenrollment. About 2.9% (586 people) died during follow-up. For the entire group, the crude all-cause mortality rate was 15.3 per 1,000 person years. It was 6.2 per 1,000 for overdose mortality.

Among the 6,948 who experienced disenrollment, the all-cause mortality rate was 17.6 per 1,000, compared to 14.7 per 1,000 among those who were not disenrolled. For overdose deaths among those who lost their insurance, the mortality rate was 8.9 per 1,000 compared to 5.4 per 1,000 person-years among those who were not disenrolled.

These findings were reported in Health Plan Disenrollment and Mortality After Initiation of Medications for Opioid Use Disorder by Anh P. Nguyen, Ph.D.; Ingrid A. Binswanger, M.D.; Komal J. Narwaney, Ph.D.; and colleagues. They concluded that the increased mortality risk among people receiving medications for OUD who are disenrolled suggests that improving continuity of health coverage may reduce mortality risk during insurance transitions.

The full text of Health Plan Disenrollment and Mortality After Initiation of Medications for Opioid Use Disorder was published on March 4, 2026, by JAMA Psychiatry. A free abstract is available (accessed March 18, 2026).

For more information, contact: Anh P. Nguyen, Ph.D., Assistant Professor, Health Systems Science, Institute for Health Research, Kaiser Permanente Colorado, Post Office Box 378066, Denver, Colorado 80237-8066; Email: anh.p.nguyen@kp.org; Website: https://medschool.kp.org/faculty/members/anh-p-nguyen