Opioid crisis threatens GOP ObamaCare repeal – The Hill

 In U.S.
Fears that cuts to Medicaid could exacerbate a national opioid epidemic that took more lives last year than the Vietnam War have emerged as a huge threat to the Senate GOP’s ObamaCare repeal-and-replace bill.

The legislation includes a $2 billion fund to help people with substance use disorders, but critics say that’s not enough to make up for the deep cuts to Medicaid that would come if the bill becomes law.

“It’s just unconscionable to me that anybody who is serious about dealing with this opioid addiction could be satisfied with the bill — even supporting $45 billion, let alone $2 billion,” Michael Botticelli, the director of the Office of National Drug Control Policy under President Obama, told The Hill. He said the bill would “really have disastrous consequences for people who are struggling with opioid addiction.”

Sens. Shelley Moore CapitoShelley Moore CapitoOpioid crisis threatens GOP ObamaCare repeal Sanders to headline ‘Don’t Take Our Health Care’ bus tour The Hill’s Whip List: Senate ObamaCare repeal bill MORE (W.Va.) and Rob PortmanRob PortmanOpioid crisis threatens GOP ObamaCare repeal A tale of two drug bills — one proposed bill will worsen the drug prices crisis Sanders to headline ‘Don’t Take Our Health Care’ bus tour MORE (Ohio) want substantial more dollars to go toward the opioid epidemic, and $2 billion in funding for the next fiscal year is a far cry from the pair’s proposal for $45 billion over a decade.The opioid epidemic has hit West Virginia and Ohio particularly hard. Both states expanded Medicaid, and nearly 30 percent of those receiving health coverage through Medicaid expansion have a mental health or substance use disorder or both, according to the National Council for Behavioral Health.  

Both states also went for President Trump in the 2016 election, adding an intriguing wrinkle to the political discussions. Trump desperately wants the healthcare win, but also reportedly described the House legislation as “mean.” How blue-collar voters interpret the GOP legislation overturning ObamaCare could have long-lasting political repercussions.

“The lack of robust funding for opioids is just one problem in this bill, but a big one,” a Senate GOP aide wrote in an email. “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.”

Medicaid, which helps low-income and disabled people, is a large payer of behavioral health services. Starting in 2025, the Senate bill will begin to cut Medicaid deeper than the House bill, as the cap on Medicaid payments would grow at a slower rate, known as CPI-U.

The legislation also ends extra federal funds for ObamaCare’s Medicaid expansion, though over a longer period of time than the House’s version, which halted the money in 2020. The Senate bill phases the program out slowly from 2021 to 2024, which is shorter than the seven-year transition Portman and Capito wanted.

Their thought is a robust fund would help offset changes to the Medicaid program.

On Thursday, neither Portman nor Capito took a strong stance for or against the bill — but both indicated the opioid epidemic was critical in their evaluation of the legislation.

In a statement, Capito said she would review the text over the next few days, “using several factors to evaluate whether it provides access to affordable health care for West Virginians, including those on the Medicaid expansion and those struggling with drug addiction.”

Portman’s statement was stronger, saying although there were some “promising changes” to lower premiums, he still had “real concerns about the Medicaid policies in this bill, especially those that impact drug treatment at a time when Ohio is facing an opioid epidemic.”

Majority Leader Mitch McConnellMitch McConnellOpioid crisis threatens GOP ObamaCare repeal Trump making calls to senators on healthcare bill Trump called Cruz to press him on ObamaCare repeal bill: report MORE (R-Ky.) faces a serious challenge in getting the legislation through the Senate and cannot afford to lose Capito and Portman.

Even with their votes, he does not have the support he needs now to move the bill given opposition from a quartet of conservatives  along with Sen. Dean HellerDean HellerOpioid crisis threatens GOP ObamaCare repeal Trump making calls to senators on healthcare bill Trump called Cruz to press him on ObamaCare repeal bill: report MORE (Nev.), the most vulnerable Republican up for reelection next year. McConnell can only afford two defections.

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