GOP Medicaid cuts would hit states fighting opioid epidemic
The Republican drive to roll back Barack Obama’s health care law is on a collision course with a national opioid epidemic that’s not letting up.
Medicaid cuts resulting from the GOP legislation would hit hard in states deeply affected by the addiction crisis and struggling to turn the corner, according to state data and concerned lawmakers in both parties.
The House health care bill would phase out expanded Medicaid, which allows states to provide federally backed insurance to low-income adults previously not eligible. Many people in that demographic are in their 20s and 30s and dealing with opioid addiction. Dollars from Washington have allowed states to boost their response to the crisis, paying for medication, counseling, therapy and other services.
According to data compiled by The Associated Press, Medicaid expansion accounted for 61 percent of total Medicaid spending on substance abuse treatment in Kentucky, 47 percent in West Virginia, 56 percent in Michigan, 59 percent in Maryland, and 31 percent in Rhode Island. In Ohio, the expansion accounted for 43 percent of Medicaid spending in 2016 on behavioral health, a category that includes mental health and substance abuse.
Those states accepted the Medicaid expansion and represent a crosssection of places hardest hit by the overdose epidemic, which claimed more than 52,000 lives nationwide in 2015. Of the deaths, more than 6 in 10 were due to opioids, from prescription pain relievers like oxycodone to street drugs like heroin and an elephant tranquilizer.
Tracy Plouck, Ohio’s director of mental health and addiction services, said Medicaid detox, but not for longterm treatment. Wright would relapse. With Medicaid, he’s been able to get follow-up.
“It’s truly sad, but I’ve been to many funerals since I’ve been clean,” said Wright, who’s in his mid-20s. “I just think Medicaid — honestly — it saves people.” And he’s able to work.
The House GOP bill would end the extra funding states get through expanded Medicaid in 2020, and place a limit on overall federal spending for the program in the future. People already covered like Wright would be grandfathered in as long as they continue to meet eligibility requirements. But that’s no comfort to Carolyn Givens, who runs the Neil Kennedy Recovery Center, where Wright gets help.
“If somebody could say to me, ‘Carolyn, the crisis is going to be over next week,’ I’d feel OK — but I got 40 people on a waiting list,” Givens said.
Medicaid cuts have become a major sticking point in the Senate for the GOP’s American Health Care Act. Republican leaders can only afford to lose two votes, and several GOP senators from hard-hit states have been critical. Sen. John Thune, R-S.D. said Tuesday that senators are considering extending the phase-out That reflects increases approved by Congress beyond what Medicaid spends.
Questioned by Sen. Patrick Leahy, D-Vt., about the consequences of reducing Medicaid’s commitment, Price responded that more government spending is not the answer.
“Let me respectfully suggest … that the programs that are out there by and large are not working,” Price said. “We are losing more Americans today than we did last year … clearly we’re moving in the wrong direction.”
Price suggested that states would be more effective with the greater flexibility promised by the GOP plan for Medicaid.
Said Leahy: “As a child I believed in the
Sen. Shelley Moore Capito, R-W.Va., wasn’t convinced either. “I’m having trouble, as many of us are, reconciling your stated goal (about the opioid crisis) being one of your top three priorities with these dramatic cuts, “she said to Price during the hearing.
Cutting financing for the Medicaid expansion “would create an unsustainable financial obligation” for West Virginia, said Allison Adler, a spokeswoman for the state’s health department.
Back in Youngstown, recovering addict Niki Campana says “it’s like the apocalypse around here.” Campana is helping other women with drug problems.
“I work with a lot of girls that struggle,” she said at the Kennedy treatment center. “We can get them on Medicaid in a day and get them in treatment. For that not to be able to happen, that would be horrible.”
Associated Press writers Adam Beam in Frankfort, Kentucky; Becky Bohrer in Juneau, Alaska; Randall Chase in Wilmington, Delaware; David Eggert in Lansing, Michigan; Morgan Lee in Santa Fe, New Mexico; Ben Nuckols in Washington; Wilson Ring in Montpelier, Vermont; Michelle R. Smith in Providence, Rhode Island; Michael Virtanen in Morgantown, West Virginia; and Brian Witte in Annapolis contributed to this report.
Above: Paul Wright smokes a cigarette, Thursday, June 15, 2017, at the Neil Kennedy Recovery Clinic in Youngstown, Ohio. Republican efforts to roll back “Obamacare” are colliding with the opioid epidemic. Cutbacks would hit hard in states that are deeply affected by the addiction crisis and struggling to turn the corner. The issue is Medicaid, expanded under former President Barack Obama. Data show that Medicaid expansion is paying for a large share of treatment costs in hard hit states. Below right: Niki Campana, left, and Paul Wright stand together outside the Neil Kennedy Recovery Clinic, Below left: Paul Wright shows a picture of himself in the hospital after a near fatal overdose in 2015. (AP photos/David Dermer)