Only about 5% of adults in Medicaid expansion states who were hospitalized for substance use or mental health disorders in third-quarter 2015 lacked health insurance, down from 20% in 2013, according to a new report by the Department of Health and Human Services. Including non-expansion states, 11% of adults hospitalized for substance use or mental health disorders lacked health insurance in third-quarter 2015, down from 21% in 2013, HHS said. “The same trends have occurred in the states most affected by the opioid epidemic,” HHS said.