March 10, 2017

ICYMI: Public Health and Substance Misuse Treatment Experts Say Trumpcare “Could Exacerbate the Opioid Crisis”

ICYMI: Public Health and Substance Misuse Treatment Experts Say Trumpcare “Could Exacerbate the Opioid Crisis”


WASHINGTON – According to public health and substance misuse treatment experts, Trumpcare “could exacerbate the opioid crisis” by ending Medicaid expansion, cutting and capping the traditional Medicaid program, eliminating provisions requiring Medicaid to cover behavioral health and substance use disorder services, and leaving more individuals uninsured.


Here’s what a few of the experts are saying:


Emily Kaltenbach, the Drug Policy Alliance’s senior director of national criminal justice reform strategy: “This plan would be a disaster for individuals who are struggling with problematic drug use, currently enrolled in treatment services, or would want to be.”


Joshua Sharfstein, associate dean at Johns Hopkins Medical School: “Taken as a whole, it is a major retreat from the effort to save lives in the opiate epidemic.”


Gary Mendell, founder of the anti-addiction organization Shatterproof: “It’s been a bipartisan effort to attack the opiate epidemic, and now Republicans are putting fighting the opiate epidemic in the back seat to politics.”


And see below for highlights of coverage:


Vice: The Opioid Crisis Would Probably Get Worse Under Trumpcare


Republicans have finally unveiled their plan to replace Obamacare, but the proposal is already under attack — from other Republicans. Among them are GOP governors who warn that the proposal could have disastrous consequences for states struggling to combat the surge in opioid overdoses.


Republicans have long expressed their desire to cut funding for Medicaid, limit enrollment, and do away with rules that require coverage for mental health and substance abuse treatment. And the plan would do just that, gradually rolling back the Affordable Care Act’s expansion of Medicaid, which provides health insurance to roughly 11 million low-income people in 31 states, including Ohio and Kentucky, two places among the hardest hit by the opioid epidemic.


… Several public health and drug policy experts who spoke with VICE News about the Republican healthcare proposal went even further, saying the changes to Medicaid — combined with other parts of the plan — could exacerbate the opioid crisis.


… Brendan Saloner, an assistant professor at the Johns Hopkins Bloomberg School of Public Health, said the Republican proposal includes changes that will allow insurance companies and state Medicaid plans to turn away drug users.


“They’re going to be engaging in a lot of tactics to essentially repel people from enrolling in their plans if they think they have high-cost conditions like substance use disorders,” Saloner said. “I anticipate there’s going to be a lot more discrimination and a lot more potential for people with substance use disorders to fall through the cracks.”


Cuts to Obamacare could result in more people with addiction problems going untreated, Saloner warned, creating “a lot of downstream negative public health consequences” that end up costing U.S. taxpayers more in the long run.


… Beyond leaving people uninsured, the experts warned of several other ways the Republican proposal would deepen the opioid crisis. Kaltenbach said the Medicaid changes could cause recovering drug users to lose access to medically assisted treatments like Suboxone, which has proven to be enormously effective at curbing overdoses. Eliminating affordable access to these treatments virtually guarantees that addicts will return to heroin and other illicit opioids, she said.


Washington Post: GOP health-care bill would drop addiction treatment mandate covering 1.3 million Americans


The Republican proposal to replace the Affordable Care Act would strip away what advocates say is essential coverage for drug addiction treatment as the number of people dying from opiate overdoses is skyrocketing nationwide.


Beginning in 2020, the plan would eliminate an Affordable Care Act requirement that Medicaid cover basic mental-health and addiction services in states that expanded it, allowing them to decide whether to include those benefits in Medicaid plans.


he proposal would also roll back the Medicaid expansion under the act — commonly known as Obamacare — which would affect many states bearing the brunt of the opiate crisis, including Ohio, Kentucky and West Virginia. Thirty-one states and the District of Columbia expanded Medicaid under the ACA.


“Taken as a whole, it is a major retreat from the effort to save lives in the opiate epidemic,” said Joshua Sharfstein, associate dean at Johns Hopkins Medical School.

Advocates and others stress that mental-health disorders sometimes fuel drug addiction, making both benefits essential to combating the opioid crisis.


… Stripping away addiction treatment services from low-income people is especially harmful, Frank, of Harvard, said in an interview, because the prevalence of drug abuse is much higher for people living well below the poverty line. He said Medicaid recipients who are covered for addiction treatment and maintain their coverage through 2020 would not lose the benefit under the GOP proposal. But, he added, because addiction is a chronic-relapse disease, people may get clean, relapse, stop working and need to go back on Medicaid.