Political opinions aside, we can all agree that how the Trump administration handles the current opioid epidemic is crucial and will have a tremendous impact on the nation. During his campaign, Trump described the rising number of opioid-related overdoses as a “crippling problem throughout the United States” and vowed to make it one of the administration’s top priorities. During the last month, several legislations have been proposed that could greatly affect the opioid epidemic and drug addiction in general.
American Health Care Act (AHCA)
The AHCA, which repeals and replaces the Affordable Care Act (ACA) also known as Obamacare, was passed by the House on May 4, 2017 and is awaiting Senate approval. It includes several changes to the previous health care reform, including an alteration of how tax credits will be distributed and cuts to Medicaid, which some experts are claiming will leave 24 million people uninsured by 2026. But how will the AHCA affect those suffering from addiction?
Under AHCA, states can seek a waiver from covering pre-existing conditions. If your state obtains this waiver, and you are one of the 18 million Americans who purchases your insurance through the marketplace you might be affected.
- Alcohol and drug addiction are considered pre-existing conditions.
- Mental disorders, which can accompany substance abuse, are also considered pre-existing conditions.
By 2020, the AHCA will eliminate the requirement to cover basic mental-health and addiction services. Clinicians and advocates claim that if individuals in recovery lose coverage or must pay higher premiums they might have to forgo important steps of recovery such as continuing care treatment. While treatment sets a strong foundation for sobriety, long-term success is achieved with continued support which people in need might not able to receive without insurance coverage.
Medicaid and Tax-Credits
The AHCA plans to phase out the Medicaid expansion put in place by Obama and pull back on Obamacare’s tax credits, which will ultimately make insurance significantly more expensive for older lower-income Americans.
Medicaid, which benefits low-income individuals, was responsible for paying for 25 percent of drug abuse treatment in 2014. It is also responsible for paying for almost 50 percent of medication-assisted treatment in Ohio, one of the states who has been hit the hardest by the opioid epidemic. The proposed $800 billion cut to Medicaid under AHCA will greatly limit access to treatment. Even if some can obtain coverage for treatment, they might not have all treatment options available to them. Medication-Assisted Treatment, which is one of the most expensive treatments, will likely not be covered in most states.
Recently the Trump administration revealed their plans to cut next year’s budget for the Office of National Drug Control Policy, the agency currently leading the fight against opioid addiction, by 95 percent. The budget cuts also include eliminating the High Intensity Drug Trafficking Areas Program whose efforts are to reduce drug trafficking, and the Drug-Free Communities Support Program, which funds youth substance abuse prevention programs.
While these budget cuts have been met with great opposition from both Democrats and Republicans, there are some who believe that the opioid epidemic has worsened immensely under the watch of the Office of National Drug Control Policy, and they believe that change is needed. What that change is remains unclear.
Mandatory Minimum Sentences
Attorney General Jeff Sessions is calling for tougher consequences when it comes to drug related crimes. He is in favor of mandatory minimum sentencing, even for low-level offenses, which both Democrats and Republicans have opposed, as they claim it would be expensive and ineffective at having a real impact on the current drug epidemic.
Session claims that stronger sentencing will keep America safe. But Kevin Sharp, a former federal judge, claims that mandatory sentencing could send low-level drug offenders to prison for life which is far from justice. Sharp claims that he has yet to encounter a judge who believes that mandatory sentencing is effective.
Advocates claim that this could set back the clock on how America views substance abuse and go back to the days of criminalizing addiction.