Drug overdoses killed a little over 52,000 people in the United States in 2015 and about 60,000 in 2016 – more than car accidents or gun violence. CPPP is joining the national Drug and Alcohol Addiction Week of Action in an effort to protect access to essential substance use disorder services.
But Republicans in the U.S. Senate are trying to force through a disastrous health care bill that would roll back gains made in improving access to mental health and substance use disorder (MH/SUD) treatment over the past decade. The Senate health care repeal bill cuts MH/SUD services while the country is in the midst of a spiraling opioid epidemic.
The impact of the Senate health care repeal on addiction services
Not enough funding for SUD services: During the drafting of the Senate bill, Sen. Rob Portman (R-OH) and Sen. Shelley Moore Capito (R-WV) requested $45 billion over ten years to address the opioid epidemic, and the latest word is that the Senate bill will include this funding.
However, the $45 billion comes nowhere near the $183 billion estimate from Harvard University health economics professor, Richard Frank, for covering the cost of opioid addiction treatment and related illnesses, like Hepatitis C and HIV. Senator Capito has also indicated that the fund alone is inadequate and that more generous Medicaid provisions are critical, saying, “You won’t access the [substance abuse] treatment without the [health insurance] coverage, whether from the exchanges or Medicaid.”
Dramatic cuts to Medicaid funding: Medicaid is the largest source of funding for addiction services across the country. In states hit hard by the opioid epidemic, like West Virginia and Ohio, Medicaid pays for 40 percent of buprenorphine, a lifesaving addiction medication. The Senate bill caps and dramatically cuts the amount of money the federal government gives states under Medicaid with a direct impact on funding for addiction treatment.
Medicaid Expansion repeal by 2025: The ACA expanded Medicaid eligibility to cover 11 million more people in the 31 states that opted to expand the program. (Texas failed to take up this option.) Medicaid Expansion has been essential for SUD treatment in states that expanded. The proportion of hospitalizations of people with MH/SUD who were uninsured fell from 20 percent in 2013 to five percent in 2015 in these states.
The proposed Senate bill phases out special ACA federal Medicaid Expansion funding, and imposes caps on federal Medicaid funds to the states for all Medicaid participants. The independent Congressional Budget Office estimates that these changes will reduce Medicaid enrollment by 15 million people in 2026.
The Senate bill will cut Medicaid spending during a current surge in overdose deaths that has led to a public health crisis. A small amount of federal emergency opioid response funding is not the same as reliable access to needed health care. Tackling addiction requires reliable health care coverage and access to long-term treatment and recovery supports. Passage of this dangerous bill could mean a return to a time when state Medicaid programs and private insurers covered only short-term minimal treatment for SUD, if they covered it at all.
Call your Senators today to remind them that the bill would harm people with substance use disorders and devastate any state effort to address addiction, more information here.