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Representatives Fear that Cuts to Medicaid May Fuel the Opioid Epidemic

Last year, the opioid epidemic in this country killed more people than those who were killed in the Vietnam War. Now, representatives are expressing their fear that cuts to Medicaid, like those proposed in the GOP's repeal-and-replace bill, will only serve to fuel the opioid epidemic by making it harder for people to get their prescriptions legally. Conversely, the legislation also includes $2 billion in funding for helping people cope with issues related to substance abuse.

However, the fear is that this will do nothing to make up for the significant slashes to Medicaid that would happen if the bill becomes law. Michael Botticelli, the former director of the Office of National Drug Control Policy – and someone who has had personal experience in attempting to treat a long-term substance abuse problem – believes the bill would “have disastrous consequences for people who are struggling with opioid addiction.”

Republican Senators Shelley Moore Capito (W.Va.) and Rob Portman (Ohio) had proposed $45 billion in funding, which is a good deal more than the $2 billion included in the new bill. Portman and Capito come from two states that were hit especially hard by this epidemic. Both states expanded their Medicaid coverage, and about 30 percent of residents who are receiving it have mental health issues, issues with substance abuse, or both.

One Senate GOP aide wrote, of his concerns about the bill, that "We have to ensure that those currently receiving opioid treatment under Medicaid expansion can continue to have treatment under a new system. And right now, that wouldn’t happen." Neither Portman nor Capito took a strong position either for or against the bill. However, they both indicated their concern that the opioid epidemic was crucial in their evaluation of the proposed legislation.

What makes Medicaid especially important to preserve is the fact that it helps people who are disabled and who come from low-income backgrounds by paying generously for their behavioral health services. Should this new bill go through, the Senate would begin to cut Medicaid in 2025. Senate Majority Whip John Cornyn (R-Texas) said about the bill that it would "continue to change and this is going to be an ongoing negotiation until Tuesday or thereabouts when the leader will then have to file the bill on the Senate floor.”

Former administration officials under Obama say that while $2 billion is not enough money to fund Medicaid, neither is $45 billion, considering the state of the country's epidemic at the moment. Said Botticelli: “Many of the people who are promoting this bill, I’ve spent countless hours in their states and districts. They fully understand the magnitude of this issue, and they fully understand what the impact of this bill is going to have for people in their states with addiction.”

Rebecca Farley David, the vice president of policy and advocacy at the National Council for Behavioral Health, agrees that the proposed $45 billion budget over a period of 10 years is "woefully inadequate." So, of course, she was not a fan of the much smaller $2 billion budget proposal: "Although $2 billion does seem like a larger number, it's just paltry in comparison to the scope of the need for opioid treatment in this country. It's laughable almost.”