GOP Med­i­caid cuts would hit states fight­ing opi­oid epi­demic

Walker County Messenger - - Front Page - By Ri­cardo Alon­soZal­divar

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)

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