Senate Health Care Bill is a Disaster for Dealing With the Opioid Crisis

WASHINGTON — The health care bill unveiled by Senate Republicans on Thursday includes funding to help tackle the nation’s opioid crisis — but dramatically less than the amount sought by two GOP senators and recovery advocates.

Sens. Rob Portman (Ohio) and Shelley Moore Capito (W.Va.) at one point had requested $45 billion over the course of a decade to keep the battle against opioids on the nation’s front burner. The bill instead would allocate only $2 billion, all in 2018.

“Well, they did say there’s some opioid funding,” Capito said as she emerged from the meeting in which GOP leadership walked through the bill with members. But, she added, the number falls far short of what she wanted.

The massive influx of money would have at least partially helped make up for the Senate’s proposed rollback of Medicaid, which pays for roughly half of addiction treatment in many states. In West Virginia, it funds nearly 45 percent of addiction treatment costs. In Ohio, the figure is 49.5 percent.

While the opioid epidemic is not limited to that pair’s states, most other Republicans did not join the call for including a major opioid epidemic funding stream through their health bill.

“I think it’s not unreasonable to think carefully about how much money you can add to the system all at once,” said Sen. Roy Blunt (R-Mo.), who chairs the Senate’s health appropriations subcommittee. “We tripled the money two years ago, then doubled the tripling. So we’re in a fairly fast trajectory, and I don’t know how much money you can effectively spend here.”

Blunt, however, acknowledged Capito and Portman’s expertise on the issue and maintained that funding addiction treatment was a priority for his subcommittee and for Congress in general.

Some advocates for the recovery community suggested the proposal for $45 billion in funding overlooked the complicated spiral in health issues that can be brought on by addiction. The additional funding, for instance, wouldn’t help cover treatment for conditions that are common among those struggling with addiction and that would otherwise be covered by Medicaid.

Senate drafters of the bill, by not including the new funding, could give either Capito or Portman — both of whom hail from Medicaid expansion states and have shown resistance to major cuts to the program — a sturdier stack of reasons to vote no. They could also use their resistance as leverage with Senate Majority Leader Mitch McConnell.

Or, in the outcome that worries those combating the opioid crisis the most, the issue could simply fizzle.

“The proposed $45 billion was not going to come close to being sufficient to address the epidemic that’s ravaging our country and taking more lives every day,” said Gary Mendell, the CEO of the addiction-focused nonprofit Shatterproof. “Shatterproof will continue to pressure senators to vote no on this bill that would have devastating effects for Americans with substance use disorders.”

The bill’s elimination of the Affordable Care Act’s essential health benefits provision, which largely mandated that insurers cover mental health and substance abuse treatment, was also cause for concern for stakeholders in combating the crisis.

“Eliminating requirements for coverage of key benefits, including mental health and substance use disorders and other patient protections that are part of the Affordable Care Act, will have detrimental impacts for millions,” Dr. Altha Stewart, the president-elect of the American Psychiatric Association, said in a statement.

The White House, which has said it sees efforts to address the opioid epidemic as a priority, did not immediately respond to a request for comment.