Could Senate health-care bill make opioid crisis 'worse'?
Posted June 24
During a contentious interview with CNN, Kellyanne Conway said Friday that the news media needs to cover the nation's opioid crisis more, and she beat back at suggestions that the new health care bill does nothing to improve the epidemic.
"That's not true, and that is not fair. That is so not fair," said Conway, the senior counselor to President Trump, during a back-and-forth with CNN anchor Alisyn Camerota.
She added, "It actually helps no one to peddle the false rumor that this health care bill does 'nothing' to help."
CNN took Conway up on her offer and delved into what the GOP-led bill, called the Better Care Reconciliation Act of 2017, does to address the opioid crisis. Although Conway defended the bill, those on the front lines say the bill won't help the opioid crisis -- and very well could make matters worse.
"If there's anything in the new health care bill that will help the opioid crisis, I haven't seen it," said Dr. Andrew Kolodny, co-director of the Opioid Policy Research Collaborative at Brandeis University.
"I would say the health care bill is more likely to make the opioid crisis worse, rather than better," he added. "If people right now who have opioid-addiction treatment paid for, and the health care bill results in their loss of coverage, it means people could lose their lives."
Conway told CNN that the administration has launched a "multi-Cabinet assault on this."
This month, the US Food and Drug Administration said that drugmaker Endo Pharmaceuticals must remove the opioid painkiller Opana ER from the market. "We will continue to take regulatory steps when we see situations where an opioid product's risks outweigh its benefits," FDA Commissioner Dr. Scott Gottlieb, a Trump appointee, said after the announcement.
On Friday, Conway touted $500 million in grants given to states from the Substance Abuse and Mental Health Services Administration under Health and Human Services Secretary Dr. Tom Price.
Kolodny noted that those grants are "money that came from a bill that President Obama signed on his way out." While praising the administration for talking about the issue and forming an opioid commission to look into the problem, Kolodny said it's time for the Trump team to act.
"I don't really see anything the Trump administration has done, other than just talk about the problem," he said. "What I'd like to see from the Trump administration is a large investment in building up an opioid addiction treatment system that doesn't yet exist."
The bill proposes $2 billion to boost treatment and recovery services in states next year -- far short of the $45 billion over 10 years hoped for by Sen. Rob Portman of Ohio.
Those struggling with addiction, Kolodny said, need easy access to maintenance therapy drugs like buprenorphine. He also said the government must do more to regulate opioid manufacturers to prevent new cases of people becoming addicted to opioids.
"If heroin, fentanyl and painkillers remain easier to get, then we're really not going to be able to see deaths come down."
Other experts agree,
Arthur Evans, CEO of the American Psychological Association, said the new bill will weaken Medicaid and allow states to waive essential health benefits, including for those seeking treatment of their opioid addictions.
"At a time that we are trying to get more people access to treatment, we're essentially taking away access," Evans said. "I think this really undermines any efforts that we might have in trying to curb the opioid epidemic."
The nation has not seen a reduction in the numbers of people overdosing and becoming addicted, he said, adding that "the timing of reducing the numbers of people covered by health insurance is very unfortunate."
"The thing we know about addiction is that having coverage does make a difference in terms of people's access and ultimate recovery," Evans said.
What would he tell Conway if he were to meet with her?
"The net effect is, the bill is going to make it worse," Evans said. "I don't think there's any doubt about that."
The National Alliance on Mental Illness also sharply criticized the bill, urging its supporters to call senators to voice their opposition, especially to the billions of dollars in cuts to Medicaid.
"NAMI opposes this effort to decimate our nation's already struggling mental health system," the organization said in a written statement. "We encourage senators to reject this harmful bill, and instead ensure Americans receive the mental health care they need to lead healthy and productive lives."
Ohio Gov. John Kasich, a Republican whose state is at the epicenter of the opioid crisis, said he was deeply concerned about the bill and the way it was handled behind closed doors.
"I have deep concerns with details in the US Senate's plan to fix America's health care system and the resources needed to help our most vulnerable, including those who are dealing with drug addiction, mental illness and chronic health problems and have nowhere else to turn," Kasich tweeted.
Pennsylvania Gov. Tom Wolf slammed the bill: "#BCRA makes care worse for everyone."
"The Republicans that wrote this bill don't want you to understand the damage it will cause before they vote on it," said Wolf, a Democrat.
Kasich and Wolf were among a bipartisan group of governors who wrote a pointed letter to Senate Majority Leader Mitch McConnell and Minority Leader Chuck Schumer ahead of the bill's release this week.
"It calls into question coverage for the vulnerable and fails to provide the necessary resources to ensure that no one is left out, while shifting significant costs to the states," said the letter, signed by seven governors: three Republicans and four Democrats. "Medicaid provisions included in this bill are particularly problematic."
About 11 million people gained health care coverage under Obamacare's Medicaid expansion provisions. The Senate bill would eliminate the enhanced federal funding for the program by 2024, probably resulting in low-income adults being kicked off the rolls.
For states hit hard by the opioid epidemic, addiction specialists say the loss of funding could have a devastating impact on treatment and recovery programs.
It should also be noted that although Conway seemed to suggest the media have done little to cover the opioid epidemic, CNN has reported on the issue extensively, including a story published Friday about librarians becoming an unlikely lifeline in America's opioid crisis.