As if Senate GOP leaders need more problems in attempting to dismantle the Patient Protection and Affordable Care Act (PPACA), the nation’s worsening opioid crisis threatens to throw another monkey wrench into their plans. An article in the Wall Street Journal reports that key GOP senators are hesitating to support a bill that could threaten addiction treatment for millions of Americans.

Several provisions of the PPACA allowed people seeking substance-abuse treatment to gain coverage, including an expansion of the Medicaid health program for the poor. But the House bill repealing the PPACA, passed in May, aimed to roll back that Medicaid expansion beginning in 2020 and to allow insurance companies to charge some people with drug addictions higher premiums or deny them substance-abuse coverage altogether.

Concerns about those provisions cut into Republican support for the replacement measure in the House. Of the 20 Republicans who voted against the House bill, 16 represented states that saw significant increases in drug-overdose death rates in recent years.

Two of those lawmakers hailed from Ohio, which, through that state’s PPACA expansion, has enrolled more than 500,000 new Medicaid recipients with behavioral-health needs, including those with drug addiction and different mental-health disorders.

Now, the same concerns are emerging as a sticking point as the Senate takes up the House bill and considers how to revise it.

Senator Rob Portman (R-Ohio) said in an interview that there is growing worry among fellow GOP senators that rolling back Medicaid expansion without offering other affordable options would have an outsize effect on people seeking addiction treatment, who access medications and other treatments through their insurance.

Tension between the administration and Congress on the opioid issue was on display when Health and Human Services (HHS) Secretary Dr. Tom Price testified before the Senate Finance Committee on June 8.

Senator Sherrod Brown (D-Ohio) questioned whether HHS is allocating enough money under Medicaid to fight the opioid-abuse epidemic. Seventy percent of the $939 million that Ohio spent on opioid treatment in 2016 came from federal Medicaid dollars, he said.

“You would never propose we fight cancer with a $50 million increase to a grant program,” Brown said. “How does this possibly work if you’re going to cut the biggest revenue stream to treat people?”

Price pushed back, pointing out that more than 52,000 Americans died of overdose deaths in 2015. “We continue to tolerate a system that allows for overdose deaths, and I simply won’t allow it,” Price said.

Source: Wall Street Journal (subscription required); June 11, 2017.

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