CHN: House Passes Bipartisan Package to Fight Opioid Crisis
The House overwhelmingly passed (396-14) the SUPPORT for Patients and Communities Act on June 22 as part of ongoing efforts to combat the opioid crisis. Advocates across the spectrum applauded Congress for taking action following the 21 percent increase in deaths from drug overdose from 2015 to 2016. This bill represents the most extensive piece of legislation addressing the opioid crisis thus far, as it combines 58 bipartisan bills passed over the previous several weeks. In its entirety, the passage was met with widespread support for its efforts in curbing the epidemic. Advocates and health-related groups such as the American Psychiatric Association and the American Hospital Association voiced support, calling for its passage throughout the process. The bill addresses several opioid-related issues including the expansion of access and coverage, alternatives to opioid use for pain treatment, a shift to evidence-based treatment, and the reduction of illegal drugs entering the country through the mail. A widely supported provision, Jessie’s Law requires the Department of Health and Human Services (HHS) to establish best practices in displaying a patient’s addiction history to prevent a relapse. The bill is named after Jessie Grubb, who died from an opioid overdose two years ago when her doctor—unaware of her addiction history—prescribed her oxycodone. Other notable provisions include:
- Expansion of Medicaid coverage for former foster youth under age 26 and for juveniles transitioning out of incarceration
- Student loan forgiveness for practitioners in the substance use disorder field
- Increased and improved access to buprenorphine, a form of medication-assisted treatment
- Addition of methadone clinics to the Medicaid program to treat addiction
- More money for states to fund more Medicaid providers and improve reimbursement rates
Despite overall support, some provisions of the bill were controversial, including the partial repeal of the Institutions for Mental Disease (IMD) exclusion, which prohibits the use of federal Medicaid funds for adult beneficiaries with opioid use disorder (OUD) in these institutions. Numerous civil and human rights advocates, including the Leadership Conference, fear this will limit expansion of care to those with OUD while neglecting those suffering from other substance use disorders (SUD). Although it ultimately failed to include all SUDs, the provision was expanded to include crack cocaine, which disproportionately affects African Americans.
Some Democrats such as Rep. Frank Pallone of New Jersey provided further criticism, claiming the bill doesn’t go far enough to combat the opioid crisis. Advocates recognize the House bill as a good start, but they emphasize the need for a sustainable funding stream to adequately address the issue.
Amidst funding concerns, the Senate appropriations bill covering HHS received committee approval this week and includes $3.7 billion to fight the opioid crisis, a $145 million increase. The House bill allots a similar amount of $3.85 billion, including $1 billion for State opioid response grants. Overall, opioid funding has increased by $3.5 billion (1,300 percent) since FY2015.
The Senate is expected to take up the issue this summer, but no official timeline has been established. It is unclear if Senate leadership will take up the House bill or will do its own version.