Health

How the AHCA Would Hinder the Fight Against Opioid Addiction

In October 2016, President Donald Trump gave an important speech in New Hampshire where he articulated the potential steps his administration would take to address the nation’s drug addiction epidemic. New Hampshire, like so many other states, is overwhelmed by a drug addiction epidemic that is resulting in significant loss of life and creating long-standing turmoil among thousands of families.  

During his speech, the president made a promise to the people of New Hampshire stating, “We will not only stop the drugs from pouring in, but we will help all of those people so seriously addicted get the assistance they need to unchain themselves.” Following this statement, he laid out a series of policies that was the appropriate balance of health care, healing, and law enforcement. The most important message was the president’s call for compassion.

He expressed his compassion and frustration in a single sentence, “It is tragedy enough that so many Americans are struggling with life-threatening addiction. We should not compound that tragedy with government policies and bureaucratic rules that make it even harder for them to get help.” The president repeated this promise during his Feb. 28 address to a Joint Session of Congress.

Yet that is likely what the “American Health Care Act” would do. The AHCA would, in its current form, put drug and addiction treatment and prevention programs out of reach for millions of people who rely on the Medicaid program for their health care due to significant changes in the program’s required benefit structure. Furthermore, the complicated web of Medicaid enrollment policies proposed in the AHCA stand to make enrollment in the program so difficult that thousands of eligible individuals likely will lose their coverage due to lapse in paperwork, not due to a change in their health or economic status. These are the exact types of “bureaucratic rules” that keep those in need from securing the treatments and mental health services that could help them.

According to the Centers for Disease Control and Prevention, more than 52,000 people died of drug poisoning in 2015. More than 35,000 of those deaths were due to opioid or heroin overdoses or complications related to the abuse of those drugs. Since 1999, opioid and heroin-related deaths are up 461 percent and 563 percent respectively. More than 70 people die each day in the United States due to an opioid overdose.  

In 2015, West Virginia and New Hampshire experienced 41 and 34 drug overdose deaths for every 100,000 deaths in their states respectively. These states are not alone — 26 states saw greater than a 10 percent increase in the number of drug overdose deaths between 2014 and 2015. Fourteen of those states (CT, FL, KY, ME, MD, MA, NH, NY, ND, OH, PA, RI, VT, and the District of Columbia) saw increases of greater than 20 percent — in one year. This epidemic is real. It impacts thousands of people and it is causing widespread loss of life.  

According to the Surgeon General’s 2016 Report: Facing Addiction in America, more than 20 million people have a substance use disorder, and 12.5 million Americans reported misusing prescription pain relievers in the past year. Many of these individuals and their families will turn to Medicaid for assistance and treatment. The question is will Medicaid be there for them.

Our nation has a proud history of responding to those in need. Good health care policy means good health care for the most vulnerable. It means helping, not hurting, “all of those people so seriously addicted get the assistance they need to unchain themselves.” Unfortunately, in its current form, the House AHCA fails to live up to this goal.

 

Shawn Martin is senior vice president of advocacy, practice advancement and policy for the American Academy of Family Physicians.

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