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Revenue Losses to State and Federal Government From Opioid-related Employment Reductions

Segel, Joel E. PhD*,†; Shi, Yunfeng PhD*; Moran, John R. PhD*; Scanlon, Dennis P. PhD*

doi: 10.1097/MLR.0000000000001107
Brief Reports

Objective: The main purpose of this study was to estimate the tax revenue lost by state and federal governments as a result of adverse labor market outcomes attributable to opioid misuse.

Methods: We pair existing, plausibly causal estimates of the effect of opioid misuse on the decline in the labor force from 2000 to 2016 with a variety of data sources to compute tax revenues lost by state and federal governments using the online TAXSIM calculator.

Results: We find that between 2000 and 2016, opioid misuse cost state governments $11.8 billion, including $1.7 billion in lost sales tax revenue and $10.1 billion in lost income tax revenue. In addition, the federal government lost $26.0 billion in income tax revenue.

Conclusions: By omitting lost tax revenue due to labor force exits, prior studies have missed an important component of opioid-related costs borne by state and federal governments.

Policy Implications: As more states and the federal government contemplate litigation for opioid-related damages, lost tax revenue represents an important cost that could be recouped and allocated to opioid prevention and treatment programs.

*Department of Health Policy and Administration, Pennsylvania State University, University Park

Penn State Cancer Institute, Hershey, PA

This work was supported by the Commonwealth of Pennsylvania: Office of the Attorney General under the project “Estimation of Societal Costs to States Due to Opioid Epidemic.”

The authors declare no conflict of interest.

Reprints: Joel E. Segel, PhD, 504 S Ford Building, Pennsylvania State University, University Park, PA 16802. E-mail:

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