Soaring Need, Shrinking Budget: Big Changes Looming For Addiction Treatment Services In 2017

Addiction treatment providers agree, the opioid epidemic is in full swing. Although opioid prescriptions are decreasing for some groups including veterans, fatal overdoses related to prescription opioids still accounted for more than 20,000 deaths in the United States in 2016.

Reversing this trend will require an all-hands-on-deck mentality as the country increases investments in addiction treatment services and drug abuse preventions programs. Access to addiction treatment has been a crucial tool for millions of Americans who currently receive mental health or substance abuse services through the Affordable Care Act (ACA) or under the Medicaid expansion program the ACA permitted.

Yet one of the Senate's first moves of 2017 was to approve a budget which would allow representatives to repeal the ACA without the risk of opposition-led filibusters. Despite assurances from the president-elect as recently as his press conference on January 11th that the ACA would be replaced immediately after its repeal, at this time Republicans have no comprehensive replacement plan or platform ready to offer the American public in lieu of the ACA.

Changes to funding for state Medicaid programs will also have a big impact on people seeking addiction treatment and mental health services. One aspect of the ACA up for repeal involves federally financed expansions to state Medicaid programs. Although some states, like Texas, chose not to expand Medicaid with matched funding from the federal government, many others including conservative Ohio took advantage of the expansion to extend healthcare coverage in their state. Congress is now considering significant changes to the federal government's investment in these state-expanded Medicaid programs, further jeopardizing coverage for more than a million people.

The research is clear when it comes to how important access to addiction treatment services really is. Participation in formal treatment programs including inpatient treatment and rehabilitation centers and outpatient groups is consistently shown to give the individual a real chance at an enduring recovery from addiction. Making sure people in need have access to quality addiction treatment services should be a top priority.

While there is no legislation on the horizon that could bring back health insurance for millions of Americans should the ACA be repealed, there are other promising bills that could impact the general public's access to addiction treatment services. The 21st Century Cures Act was signed into law by President Obama in December of 2016, approving block grant funds to be distributed to states and spent at their discretion. The question for the Congress is whether or not this act will be funded and if it is, how the funds will be distributed to the states.

The Comprehensive Addiction and Recovery Act (CARA) was also approved by Congress in their last session. CARA identifies standards of excellence in addiction treatment care and seeks to bolster key initiatives including public education and emergency responders' access to overdose reversal drugs in a comprehensive plan to end addiction. Even if the ACA is completely repealed without a replacement, a fully funded CARA would provide some assistance to those in need of addiction treatment services.

Ending the opioid epidemic is not a partisan issue. Congress' swift actions to repeal the ACA and Medicaid expansions without replacements does not reflect a commitment to ending our drug abuse crisis, just a refusal to prioritize the well-being of the American people.