In Criminal Justice, Medication Monitoring

Although many Democrats and Republicans agree on the need for increased access to substance abuse treatment to effectively address the opioid epidemic, treatment advocates are concerned that the House of Representatives’ newly passed American Health Care Act (AHCA) will gut funding for programs to treat substance abuse disorders enacted under the current Patient Protection and Affordable Care Act (ACA).

Specifically, critics are concerned about the bill’s caps on federal payments to state Medicaid programs. The AHCA proposes to cut Medicaid funding by an estimated 25%, or $880 billion over 10 years. However, capping Medicaid may force states to choose between programs for low-income individuals, which include mothers and children, the elderly, or drug addicts. The House’s AHCA bill also includes a provision allowing states to drop mental health and addiction services from their Medicaid plans, which is required under current law.

Another concern about the AHCA’s approach to substance abuse disorder is the loss of protection regarding pre-existing conditions. Drug addiction would almost certainly be put in this category, which would place addicts in a high-risk pool for insurance coverage. Although the final version of the House bill included $8 billion to help high-risk individuals pay the higher premiums they would face, critics say that amount is more than 20 times too small.

Although the House bill is passed, the arguments about new healthcare legislation are far from over. Rather than adopt the House’s proposal, the U.S. Senate is writing its own healthcare bill. Once the Senate has decided on its proposal, the two houses of Congress will have to reconcile the two versions before the final bill can be sent to the president for his signature.


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