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GOP health care bill endangers opioid epidemic treatment, U.S. doctors say

The new Republican health care bill could impact opioid abuse treatment.
The new Republican health care bill could impact opioid abuse treatment. Creative Commons

The largest group of doctors in the country said the new health care bill introduced by House Republicans endangers expanded treatment for opioid abuse, an epidemic that kills 91 Americans each day.

The American Medical Association wrote House Republican and Democratic leadership to express its opposition to the American Health Care Act, which Republicans introduced Monday as part of their effort to repeal and replace the Affordable Care Act.

The Republican plan modifies parts of that bill, also known as Obamacare, including a provision that allowed for state Medicaid expansion. Medicaid provides health insurance for low-income people.

“The Medicaid program, for example, has been critical in helping many states cope with the increased demand for mental health and substance abuse treatment as a result of the ongoing crisis of opioid abuse and addiction,” AMA CEO James Madara wrote. “Changes to the program, therefore, that limit the ability of states to respond to changes in demand for services threaten to force states to limit coverage and increase the number of uninsured.”

The opioid epidemic has spread rapidly across the country, particularly impacting rural areas. Nearly half of all opioid overdose deaths involve prescription opioids, which killed more than 15,000 people in 2015 according to the Centers for Disease Control and Prevention. The AMA said that reversing Medicaid expansion will negatively impact low-income patients who were able to obtain health coverage in states that chose to expand the program. An estimated 10 million people gained coverage under this provision.

The Republican bill cuts Medicaid spending by capping it at a specific amount per person starting in 2019. Because the Congressional Budget Office hasn’t scored the bill, it’s not clear how many people would lose coverage.

Four Republican senators sent a letter Monday to Senate Majority Leader Mitch McConnell, R-Ky., expressing concern that changes to Medicaid would cut off access to “life-saving health care services.”

“The Department of Health and Human Services reports that nearly one-third of individuals covered under the Medicaid expansion have a mental health or substance use disorder,” the senators wrote. “As the largest payer of mental health and substance use services in the United States, it is critical that any health care replacement provide states with a stable transition period and the opportunity to gradually phase-in their populations to any new Medicaid financing structure.”

The American Hospital Association also found the proposed GOP bill could present a dangerous drop in coverage.

“While we commend the recent actions by the Congress to address behavioral health issues, as well as the drug epidemic that is impacting virtually every community we serve, it is important to recognize that significant progress in these areas is directly related to whether individuals have coverage. And, we have already seen clear evidence of how expanded coverage is helping to address these high-priority needs.”

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