Addiction medicine experts push back against AHCA’s Medicaid cuts at first opioid commission meeting

Much of the talk at the first meeting of the Trump administration’s commission on opioids centered on a key topic: the American Health Care Act and proposed cuts to Medicaid within the bill.

The President’s Commission on Combating Drug Abuse and the Opioid Crisis hosted nine different addiction and behavioral health experts at the meeting last Friday, all of whom offered solutions and suggestions to the commission on the opioid epidemic.

In his testimony, Joe Parks, M.D., medical director for the National Council for Behavioral Health, said that Medicaid is the largest payer in the country for addiction and mental health treatment.

“Since the majority of increased opiate deaths and suicide occur in young and middle-aged adults, which is the expansion population, the Medicaid expansions must be maintained and completed,” Parks said.

Mitchell S. Rosenthal, M.D., deputy chairman of the National Council on Alcoholism and Drug Dependence, said in his testimony that 30% of Medicaid patients are being treated for substance abuse or a mental health disorder.

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Though concerns about Medicaid cuts were at the forefront of discussions at the commission’s two-hour meeting, the nine-person panel also sounded off on evidence-based medicine, ways to increase first responders’ access to key drugs like naloxone and how to make it easier for families to access resources if they’re coping with a relative’s addiction.

Kelly Clark, M.D., president of the American Society of Addiction Medicine, said the government should strongly back evidence-based addiction treatments.

“We need to make sure insurers are paying for evidence-based care, and not paying for treatment that is ‘evidence-based,’” Clark said. “We’re paying for spa-like treatments and things not based in science.”

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Marcia Lee Taylor, CEO of the Partnership for Drug-Free Kids, said in her testimony (PDF) that most parents seeking out ways to help their addicted children have trouble finding science-based information, which stands in stark contrast to other disorders.

Taylor said that there must be funding streams available at both the state and federal levels to better support families in this situation.

“There’s never been a more urgent need for resources to support and educate families struggling with this disease, and while growing attention has been paid to solutions to “put out the fire,” there are also solutions and steps we can take to de-escalate the problem and to address it further upstream,” she said.

In addition to the commission members, a number of key administration leaders were present, including counselors Kellyanne Conway and Jared Kushner, Department of Health and Human Services Secretary Tom Price and Department of Veterans Affairs Secretary David Shulkin.

The commission will meet again on June 26, and a draft of its report is expected ahead of that meeting. The commission’s report should be finalized by October. 

A video of Friday’s meeting is embedded below: