One hand giveth, the other taketh away. So it might seem for advocates who hope to increase access to health services for people with addiction.
In the midst of the country’s opioid epidemic, President Donald Trump’s proposed federal budget contained good news with the promise of additional money for opioid prevention and treatment. On the other hand, the proposed Republican health plan supported by Trump has those same advocates worried that repeal of the Affordable Care Act (ACA) will cut access to addiction treatment.
Trump’s budget released Thursday contained a proposed $500 million increase in the Health and Human Services Department to counter the opioid epidemic and money for the Justice Department to combat the drug problem.
However, a report in Vox raises questions about whether Trump’s budget actually is adding $500 million to fight the opioid epidemic or whether the funding comes from the 21st Century Cures Act, which was approved by Congress and President Barack Obama last year. The report says the Trump budget promises $500 million above 2016 levels and might be referring to funding that is part of the Cures Act—$500 million each in fiscal years 2017 and 2018. The Vox reporter said that after reaching out to the Trump administration there was no clear answer to whether the $500 million is new spending or was allocated in the Cures Act.
While those pressing for more resources for addiction treatment would presumably be pleased to see additional funding, there has been great concern about the impact of the proposed Republican health bill, which the Congressional Budget Office said would increase the number of uninsured Americans by 24 million by 2026.
The plan will reduce access to health services for people with addiction, according to Michael Botticelli, who served as President Obama’s director of National Drug Control Policy and pushed Congress to make more money available last year to treat addiction. “I think it's not hyperbolic to forecast that we're going to see dramatic increases in mortality associated with drug overdose deaths [if the proposed bill goes into effect],” he said in an interview with NPR.
The American Society of Addiction Medicine sent a letter (PDF) earlier this month to Congress saying the Republicans' American Health Care Act will reduce coverage for vulnerable populations, including those who suffer from addictions. The group, which represents doctors and other addiction professionals, worries the proposal will reverse progress on the opioid crisis made by the ACA, which expanded Medicaid, required health plans to cover essential health benefits such as addiction treatment and mandated plans to treat mental health services.
“This coverage is a critical lifeline for people with addiction, many of whom were unable to access treatment before the ACA’s expansion of Medicaid, and has reduced the burden of the opioid epidemic and saved lives,” the group said in an announcement.
Shatterproof, a national nonprofit organization dedicated to reducing addiction, said by placing a cap on federal Medicaid funding to states, the plan would decrease access to benefits, including treatment for substance use disorders.