Thread: GOP health-care bill would drop addiction treatment mandate covering 1.3 million Amer

GOP health-care bill would drop addiction treatment mandate covering 1.3 million Americans

By Christopher Ingraham March 9 at 7:41 AM

Republicans confirm substance abuse and mental health coverage would no longer be mandated under Medicaid expansion
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Republicans confirmed substance abuse and mental health coverage would no longer be mandated under the Medicaid expansion. Instead, individual states could decide whether or not to include mental health coverage in their Medicaid plans. (Energy & Commerce Democrats)

By Katie Zezima and Chris Ingraham

The Republican proposal to replace the Affordable Care Act would strip away what advocates say is essential coverage for drug addiction treatment as the number of people dying from opiate overdoses is skyrocketing nationwide.

Beginning in 2020, the plan would eliminate an Affordable Care Act requirement that Medicaid cover basic mental-health and addiction services in states that expanded it, allowing them to decide whether to include those benefits in Medicaid plans.

The proposal would also roll back the Medicaid expansion under the act — commonly known as Obamacare — which would affect many states bearing the brunt of the opiate crisis, including Ohio, Kentucky and West Virginia. Thirty-one states and the District of Columbia expanded Medicaid under the ACA.

“Taken as a whole, it is a major retreat from the effort to save lives in the opiate epidemic,” said Joshua Sharfstein, associate dean at Johns Hopkins Medical School.

Advocates and others stress that mental-health disorders sometimes fuel drug addiction, making both benefits essential to combating the opioid crisis.

[Where opiates killed the most people in 2015]

Nearly 1.3 million people receive treatment for mental-health and substance abuse disorders under the Medicaid expansion, according to an estimate by health care economists Richard G. Frank of the Harvard Medical School and Sherry Glied of New York University.

House Republicans confirmed the benefit cuts during a meeting of the House Energy and Commerce Committee on Wednesday. Republicans on the committee argue that the change would give states additional flexibility in coverage decisions, and believe they would continue to provide addiction and mental-health coverage to Medicaid recipients if needed.

During the committee meeting, Rep. Joe Kennedy (D-Mass.) asked a GOP staffer whether those benefits are “no longer essentially covered, or required to be covered, by this version of this text. Is that not correct?”

“The text before us does remove the application of the essential health benefits for the alternative benefit plans in Medicaid,” a lawyer for Republicans on the committee responded.

“Including mental health?”

“Yes.”

Rep. Joe Kennedy (D-Mass.) said he and Rep. Peter Welch (D-Vt.) introduced an amendment during the committee meeting to include mandates for substance abuse and mental-health coverage, but it was voted down along party lines.

Several Republican senators expressed concern about removing the benefits. Sens. Rob Portman (Ohio), Shelley Moore Capito (W.Va.), Cory Gardner (Colo.) and Lisa Murkowski (Alaska) sent a letter to Senate Majority Leader Mitch McConnell (R-Ky.) stating that the plan does not “provide stability and certainty” for individuals and families enrolled in Medicaid expansion programs, or flexibility for states.

President Trump has made combating the nation’s drug-overdose problem a focal point of his campaign and his presidency.

“We will stop the drugs from pouring into our country and poisoning our youth,” he said in a speech before Congress last week, “and we will expand treatment for those who have become so badly addicted.”

[Opioid distributors sued by West Virginia counties hit by drug crisis]

Trump has endorsed the Republican plan to replace the ACA.

“States have already been strong leaders on the opioid crisis and know the crisis within their states better than the federal government,” said a White House spokesman who was not authorized to comment and spoke on the condition of anonymity. “We expect them to prioritize the needs in their states better than the federal government ever could.”

A record number of people — 33,000 — died of opiate overdoses in 2015, according to the Centers for Disease Control and Prevention. Opioids now kill more people than car accidents, and in 2015 the number of heroin deaths nationwide surpassed the number of deaths from gun-related homicides. Authorities are also grappling with an influx of powerful synthetic narcotics responsible for a sharp increase in overdoses and deaths over the past year.

The 15 counties with the highest death rates from opiate overdoses were in Kentucky and West Virginia, according to a group of public health researchers, writing in the New England Journal of Medicine. Both of those states expanded Medicaid. Taking away those benefits, they wrote, would affect tens of thousands of rural Americans “in the midst of an escalating epidemic.”

Medicaid pays for 49.5 percent of medication-assisted treatment in Ohio, 44.7 percent in West Virginia and 44 percent in Kentucky when the drug buprenorphine, which is used to manage chronic opiate use disorder, is administered, according to Rebecca Farley, vice president of policy at the National Center on Behavioral Health.

Public health officials and advocates say there is a nationwide shortage of treatment programs to serve the growing problem of addiction and its effects, including diseases associated with long-term IV drug use such as hepatitis C and HIV.

[Heroin deaths surpass gun homicides for the first time, CDC data shows]

Shawn Ryan, a doctor with Brightview Health in Cincinnati, which provides addiction treatment mainly to patients on Medicaid, said states are starting to increase drug addiction services to respond to rising needs, but the process could take years.

“The outpatient addiction treatment services that are starting to ramp up . . . they could be crushed by this if not done in a way that specifically protects the most vulnerable populations,” he said.


Stripping away addiction treatment services from low-income people is especially harmful, Frank, of Harvard, said in an interview, because the prevalence of drug abuse is much higher for people living well below the poverty line. He said Medicaid recipients who are covered for addiction treatment and maintain their coverage through 2020 would not lose the benefit under the GOP proposal. But, he added, because addiction is a chronic-relapse disease, people may get clean, relapse, stop working and need to go back on Medicaid.

“It’s a disease that hits suddenly at various points in the life cycle,” Frank said.

Some GOP lawmakers advocate a full repeal of the ACA, a move that would result in loss of coverage for 2.8 million people, 222,000 of whom have an opioid disorder, Frank and Glied, of NYU, estimate.

Gary Mendell, founder of the anti-addiction organization Shatterproof, said the group plans to run campaigns against the rollback in eight states where Medicaid was expanded, urging people to contact their elected officials. Mendell, whose son battled addiction and died in 2011, said the drug-abuse battle has transcended party lines. Last year, Congress passed a landmark bill to fight opiate addiction.

“It’s been a bipartisan effort to attack the opiate epidemic,” he said, “and now Republicans are putting fighting the opiate epidemic in the back seat to politics.”

https://www.washingtonpost.com/news/...ion-americans/

What's wrong with that? Leave it up to the states to decide.

Drug addicts who don't get treatment usually end up in jail or prison

so one way or another the taxpayers are going to end up paying for them.


Spotlight: Mental health and prisons, the new asylums

https://apps.bostonglobe.com/spotlight/the-desperate-and-the-dead/series/prisons/
Nov 25, 2016 - And inmates with a “dual diagnosis” of addiction and mental illness, like ... The full-time mental health staff in the prisons is 25 percent smaller ...

Yeah, the addicts are a sad story. But states are the best ones to decide who, when and how much. They're a lot closer to the situation, so they can come up with the best plans to try to help these people with rehab. Rehab is hard, it takes many tries, and even then, sometimes it doesn't work. It's a really sad situation and good endings are few and far between.

3/8/17

American Medical Association Opposes GOP Health Care Plan


3/9/17

US hospitals oppose Trump-backed health bill

Yes, these are the organizations who love the rising cost of health care that results from the rising cost to government to pay for it. You can't get it from your customers, so you get it from the government. Health care is run by "charities", 80% of our US hospitals are 501 C 3 "charities". Lot of money being made in our country by the health care industry, not insurance companies, they're all mostly going broke, the money is made by the medical providers, primarily hospitals, 80% of which are "charities".

Go Figure.

I have no problem with that.

Why should I have to pay a higher premium so they get free treatment?

House GOP bill would let employers require genetic tests

Originally Posted by lorrie

I have no problem with that.

Why should I have to pay a higher premium so they get free treatment?

You shouldn't. That's why I think we should end the War on Drugs, legalize, regulate, educate, tax under the FairTax, and provide free rehab to anyone who wants or needs it with FairTaxes as well as portions of state and local sales taxes only drug users pay when they legally purchase drugs. Something to think about.

Make it a domestic only enterprise, no imports, no exports, owned and operated A to Z by trained and licensed US citizens, regulate by age to purchase, quantity and quality, require an education on the real risks and consequences of using these drugs before you purchase, watch a film, read pamphlets, pass a quiz, etc., etc., all available in the licensed stores and give them a card when they've completed and passed the quiz, put warning labels and side effects information on all packages like they do at the pharmacy with the rehab hotline number and location of nearest rehab clinic, and then stop worrying about it.

This will put the foreign drug cartels out of business.

This will keep the $300 billion a year being sucked out of our economy every year in the United States where it belongs.

This will discourage drug use through the education program when they know the risks and consequences, especially young purchasers.

This will help those who are already addicted to have access to the help they need without charge to non-drug users.

This will remove the whole issue of rehab expenses from the health insurance issue.

This will encourage people to get help they need.

This will remove all the expense of incarcerating users and ruining their lives with arrests and convictions.

This will improve the safety and reduce the deadly consequences of killer drugs resulting from bad mixes.

In general, this reduces crimes, shuts down the cartels, saves lives, helps addicts, saves taxpayers, puts the drug revenues back into the US economy, discourages use, and greatly curtails illegal immigration fueled by the drug cartels. And, if done right, generates over $70 billion a year in new federal taxes only drug users pay.

It's not going to stop all drug use or save all lives, but in my mind as a civilized society, it will be the best that we can do for all involved and all affected by this particular human frailty in our country.

I just watched Shawn Spicer daily White House briefing,

Shawn Spicer just indicated the new Ryancare would reduce monthly premiums by 10%.

Well I'm sorry traitor Ryan, who is re-writing Obamacare to accommodate his donors.....

You might as well just leave Obamacare in place because your version is worthless and does nothing to help the people who can't afford the premiums.

My pre-Obamacare 'Cadillac Insurance' cost me $248/month and it covered everything under the sun.

Under Obamacare I now pay over a $1000 month with less coverage and huge copay's.

Ryan's plan reducing my monthly premium 10% is a complete joke!

If I can't pay $1000/month, what makes you think I can pay $900/month?