Policy

Bipartisan Group Pushes Opioid Help Amid Obamacare Debate

Lawmakers concerned over potential effects of GOP health care overhaul

New Hampshire Rep. Ann McLane Kuster says the opioid epidemic has come as a surprise to many of her colleagues. (Bill Clark/CQ Roll Call file photo)

A bipartisan group of House lawmakers is fighting to keep attention focused on last session’s top health issue — abuse of prescription opioids, heroin and other drugs —  although the 2010 health care law now dominates the health policy discourse.

The group hopes to pressure Congress to provide financial support to states for prevention and treatment, even as Republicans pursue an overhaul of the Medicaid system that could make it harder for states to pay for those services.

New Hampshire Democrat Ann McLane Kuster co-chairs the Bipartisan Heroin Task Force, a group she founded with Rep. Frank C. Guinta in late 2015. Guinta, a New Hampshire Republican, lost his re-election bid last year and Rep. Tom MacArthur of New Jersey has since joined Kuster to serve as the Republican co-chairman.

New Hampshire has struggled with drug abuse and has the second-highest overdose death rate in the country. Kuster told CQ Roll Call that for members in other areas, the crisis came as more of a surprise.

One goal of the task force, she said, “was to educate my colleagues in these communities about the roots of this crisis.” The group has more than 80 members and last year pushed for a slate of opioid-related bills, some of which were included in the opioid response package signed into law last July.

“We did develop a common approach, which is education, prevention, investing in treatment and understanding that this will require long-term recovery,” Kuster said.

A House hearing last month focused on the threat posed by synthetic opioids such as fentanyl, a potent drug that can be laced in heroin and can more easily result in overdose.

While Kuster anticipates the lawmakers will have partisan disagreements about issues such as funding and repeal of the health care law, she said the group will “make sure we continue to educate our members about the impact of these various proposals on continued coverage for people seeking treatment for opioid abuse.”

Recent reports have indicated that the White House is considering abolishing the Office of National Drug Control Policy, which coordinates efforts across the federal government and with state and local authorities.

While President Donald Trump’s budget would reportedly slash programs considered duplicative or ineffective, nearly 200 health and law enforcement groups wrote to Mick Mulvaney, the new Office of Management and Budget director, to tell him that the drug control office is neither.

The office “eliminates waste and fraud in the federal government by preventing programs and strategies among various federal agencies,” the letter stated, adding that the office “brings essential expertise to the table on complex drug issues, experience that would otherwise be missing or dispersed across multiple agencies.”

During last year’s campaign, Trump framed the overdose crisis as part of his plan for border security. “A wall will not only keep out dangerous cartels and criminals, but it will also keep out the drugs and heroin poisoning our youth,” he said at a campaign rally in New Hampshire in October.

He also promised to help people struggling with addiction. One of his proposals was to lift a cap on the number of patients that doctors can treat with buprenorphine, a drug that helps limit the symptoms of withdrawal. The cap was 100 patients for many years, but the Obama administration lifted it to 275 last year.

Trump also said he would “end Medicaid policies that obstruct inpatient treatment.” He was likely referring to a policy that prevents federal reimbursement of inpatient visits in facilities with more than 16 beds. Such a move would have support from the treatment community and many in Congress, but it would likely be very expensive. The Congressional Budget Office estimated last year that it would cost up to $66 billion over 10 years, which, especially if combined with a Medicaid block grant, would severely strain state budgets.

As states brace for potential cuts, they will get at least some additional funding later this year. Last year’s “21st Century Cures” law includes $1 billion in anti-opioid funding for states, to be distributed over a two-year period. State applications for those grants were due in mid-February to the Substance Abuse and Mental Health Services Administration, and awards like that are typically distributed by the fall.

The other major legislation passed last year to combat opioids authorized around $180 million in grants at the Department of Health and Human Services and the Department of Justice, but so far only about $18 million has been appropriated as part of last year’s stopgap spending measures. As Congress funds the government for the remainder of fiscal 2017, securing the rest of that funding will be a main priority of the bipartisan task force, according to Kuster.

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