Author: Justin Mckibben
The new Trumpcare plan, formally known as the American Health Care Act or AHCA was announced this Monday March 6th. This Trumpcare bill is the Republican Party’s long awaited plan to repeal and replace the Affordable Care Act, also known as Obamacare.
Since day one of the announcement we have seen quite a few varying opinions as to what this means for the people who were previously covered, and what it means for how healthcare altogether might change. Needless to say, not that much of the talk has been optimistic. As details emerge about Trumpcare some have become increasingly worried about the impact it will have on access to treatment for substance use disorder, especially for low-income Americans.
So what some are officials and experts saying about Trumpcare, and what it might mean for Americans struggling with addiction?
Early Predictions on Trumpcare
According to some early reports, 6-10 million Americans will lose health insurance. Not only that, millions of people in desperate need of help could be cut off from access to addiction treatment as a result of the bill.
In fact, according to one analysis, approximately 2.8 million people living with substance use disorder will lose some or all of their health insurance coverage if Obamacare is repealed. This conclusion comes from:
- Harvard health economist Richard Frank
- Sherry Glied, Dean of the Wagner School of Public Service at NYU
The publication The Hill reported in January that Frank and Glied predict that the federal government’s 21st Century Cures Act creates a recent investment of $1 billion to tackle opioid abuse. However, they state this provision would be- “squandered if the new Congress rolls back recent gains in the quality and level of substance use and mental health insurance coverage generated by the Affordable Care Act (ACA) of 2010.”
Surely this is all “fake news” and “alternative facts” right?
Not so much. According to reports from the Washington Post Thursday, House Republicans admitted, after questioning by Massachusetts Democratic Representative Joe Kennedy III, that their the Trumpcare plan to repeal-and-replace would- “remove a requirement to offer substance abuse and mental-health coverage that’s now used by at least 1.3 million Americans.”
How does this happen? By attacking the expansion of Medicaid and the ‘essential benefits’ states are required to provide for.
Trumpcare Impact on Medicaid
Trumpcare’s plan to roll back Medicaid and health insurance tax credits are pretty distressing aspect of this reform. For all the Americans who rely on government assistance for addiction treatment this is a pretty huge deal.
Addiction treatment in the past is notably impacted by Medicaid. According to Truven Health Analytics, Medicaid was the second largest payer for addiction treatment, after state and local programs, in 2014.
Starting in 2020, Trumpcare is set to:
- Freeze Medicaid enrollment
- No longer require Medicaid to cover essential health benefits like addiction treatment
What is the point? To make it so the federal government pays less for Medicaid over time by shrinking coverage.
So if this is all the case, it is a terrifying reality. In a time when more Americans than ever desperately need addiction treatment, in the midst of an opioid epidemic that is tearing families and communities apart, the government’s Trumpcare plan stands to save money by stripping addiction resources from those relying on Medicaid?
Representative Kelly and Peter Welch, Democratic Representative from Vermont, attempted to amend the bill to restore the federal mandate for those ‘essential benefits’ but were voted down. Kenny is popularly quoted in the news recently for his statement,
“There is no mercy in a country that turns their back on those most in need of protection: the elderly, the poor, the sick, and the suffering. There is no mercy in a cold shoulder to the mentally ill… This is not an act of mercy — it is an act of malice.”
While Trump’s comments say he wants to give states “flexibility” with Medicaid to make sure no one is left out, many believe this is just adding the idea of paying more for less.
Senate Minority Leader Chuck Schumer vows to lead efforts to defeat Trumpcare, stating he believes it will “Make America Sick Again” and believes that it will create more drug addicts. In a report from The Hill Schumer attacks the bill saying,
“To make matters worse, this sham of a replacement would rip treatment away from hundreds of thousands of Americans dealing with opioid addiction, breaking the President’s word that he would expand treatment, not cut it.”
This is continuously troubling. When it comes to the fight against addiction, President Trump’s administration seems to be more focused on borders and “law and order” than providing resources. Trump did promise to work on creating more coverage options, but all the action taking place almost points the opposite direction.
Trumpcare Impact on Treatment Providers
This chain reaction wouldn’t just hurt those who need insurance by denying them coverage. Experts say Trumpcare also has the capacity to do damage to the treatment providers themselves.
Keith Humphreys, a drug policy expert at Stanford University, points out this issue directly. Humphreys notes that treatment providers, which tend to be small businesses in many parts of the country, may find it difficult to stay in business if clients lose coverage for addiction treatment. If less people are able to get coverage, less people will be able to get treatment. At the same time even bigger treatment providers could have trouble because it still has the capacity to reduce reimbursement rates for treatment services.
Thus, Trumpcare could affect both the supply and quality of treatment. In one interview Humphreys states,
“Most providers are small, mono-business entities that can’t absorb costs elsewhere in their care systems,”
“While hospitals will not go broke if poor people get less oncology care coverage, many [substance use disorder] treatment agencies will.”
But it isn’t just Democrats or University Professors or addiction experts speaking out. The AARP, the American Hospital Association, and the American Medical Association voice opinions against the overhaul of the ACA and the potential harm Trumpcare could do.
Even Republicans are speaking out against the danger that Trumpcare poses to addiction. Ohio Governor John Kasich is vocal with his own opposition to the bill saying,
“[Trumpcare] unnecessarily puts at risk our ability to treat the drug-addicted mentally ill and working poor who now have access to a stable source of care.”
Not to say that healthcare was ever perfect. It is noted by many doctors in the addiction field, as well as politicians and other experts, that there is already a treatment deficit. Approximately 10% of America’s population has what could be considered a substance use disorder, and only 13% of those people ever get treatment.
However, the miles of red tape Trumpcare might wrap around them could cut that number drastically. So even if these are unintended consequences, they are very real consequences just the same.
Obamacare was far, far from perfect. This is absolutely true. But is Trumpcare the best answer we can come up with?
As it now stands, Trumpcare may take so much away from those struggling with addiction and mental health that some experts are calling it dangerous. Having safe, effective and comprehensive treatment resources for these issues is extremely important to the preservation of life and the future of America. This is a matter of life and death. It is not the time for an ‘anything but Obamacare’ mentality… if the government expects a better plan, they need to make it happen. How about we put a hold on spending billions on border walls and expanding the nuclear program, and instead focus on healing Americans who need it most.
If you or someone you love is struggling with substance abuse or addiction, think about who you want to be working with to find a real solution. Please call toll-free now.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
Many months back, when President Trump was still on the campaign trail, he was asked about the opioid epidemic in America during a Q&A in Ohio. He said the solution was about cutting it off at the source through the southern border. President Trump continues this narrative in a more recent solo press conference, suggesting the United States is becoming a “drug infested nation,” and he added,
“Drugs are becoming cheaper than candy bars.”
So what is President Trump’s plan to fight addiction, and will it help addicts?
President Trump on Cartels
By now we all know President Trump believes there is a direct correlation between the drug epidemic in America and what he calls an epidemic of illegal immigration. In the past he has pointed to the infamous border wall as the answer to cutting off the heroin trade into America, which he seems to believe is the primary source of the problem. During his press conference he adds,
“We’ve ordered the Department of Homeland Security and Justice to coordinate on a plan to destroy criminal cartels coming into the United States with drugs,”
President Trump went on to say,
“We have begun a nationwide effort to remove criminal aliens, gang members, drug dealers and others who pose a threat to public safety.”
To be fair, we must acknowledge the relevance of cartels in the drug trade. Since the 90’s some statistics show that the primary supplier of heroin to North America is pretty consistently Latin America and Mexico.
However, to believe that Mexican cartels are the only element of the opioid epidemic is a mistake we can’t afford to make. And blaming an entire country for drug dealers and gangs is a bit out of step with the history of drugs and gang violence in America. While it cannot be denied that Mexican cartels have a role in all this, solving the addiction problem is a lot bigger than that. Besides the fact that heroin is not only from Mexico, heroin is definitely not the only problem.
President Trump on China
For example, what do you know about fentanyl? That is, the incredibly dangerous opiate that has created such a overwhelming panic as a result of steep spikes in overdoses and deaths. Did you know it originates from Chinese suppliers?
According to some lobbyists, there are some clues that could imply President Trump plans to prosecute drug traffickers and close shipping loopholes that include drugs coming in from China and other areas.
So far, however, there isn’t much mention out there about these ideas. It seems the majority of the statements being made openly are singling out Mexico. It might be time to talk more on these other areas they plan on addressing. There is some value to stopping these dangerous drugs from getting here, but we also have plenty of problems here already.
President Trump on Opioid Epidemic
President Trump did release details during his campaign about his intentions for taking on the opioid epidemic, stating he plans to:
- Increase Naloxone access- the opiate overdose medication
- Encourage state and local governments to provide treatment options
- Speed FDA approval for abuse-deterrent painkillers
Yet some people are concerned because there hasn’t been much more talk about this since late in the campaign trail. President Trump has referenced a move to expand access to drug courts and raise the cap on how many patients that doctors can prescribe medication-assisted treatments. These may be very effective strategies for providing multiple opportunities for exposing addicts to recovery. But we aren’t hearing enough about those either. When the subject comes up, we should hope for more accurate information to know if addicts will get this help, instead of hearing about immigration.
Again, many still want the President to talk more openly about the contribution made by Big Pharma and prescription drugs to the issue, specifically concerning the opiate epidemic. We can only blame so much of our problems on outside influence. We have to hold our own drug companies accountable.
President Trump and Big Pharma
Trump did say throughout his campaign he would be fighting the Big Pharma companies in order to get rid of outrageous price-gouging on medications. He made a statement at one point that,
“Pharma, pharma has a lot of lobbies and a lot of lobbyists and a lot of power and there’s very little bidding on drugs,”
“We’re the largest buyer of drugs in the world and yet we don’t bid properly and we’re going to start bidding and we’re going to save billions of dollars.”
This much isn’t off base. According to the Center for Responsive Politics, drug companies and their industry allies spent more than $186 million lobbying for their interests in a year, and $1.12 billion since 2012.
Yet, the Republican Party did a great deal in 2003 under President George W. Bush to prevent federal government from interfering in negotiations between drug companies and pharmacies that participate in taxpayer-funded Medicare Plan D prescription drug benefits.
Hopefully, having a Republican Congress that isn’t constantly at odds with their President will help things move along easier; especially concerning healthcare reforms. So beyond making drugs cheaper, the question becomes what can we do about preventing dangerous and addictive drugs from getting even more out of control.
ACA and CARA
With healthcare reform, many addiction recovery advocates insist that the Comprehensive Addiction and Recovery Act (CARA) should be a priority. Many say the CARA is the most significant federal legislation pertaining to addiction in years. Still, it does not include a specific allowance of funding for the programs it has created.
Once CARA is funded, more programs will be put in place to help fight addiction. Without the funds it is a Cadillac with no engine or wheels.
Then there is the major point President Trump ran on; repealing the Affordable Care Act (ACA). This action could eliminate coverage for many Americans in recovery who had previously been uninsured. Specifically, if the government repeals the ACA without a plan to replace it or to maintain coverage for those depending on it. If President Trump and the GOP come up with a program to replace it, we may still avoid this tragedy. Still, as it stands, the idea makes plenty of people nervous.
For instance, Medicaid, the federal-state insurance for low-income people, payed for about $60 billion worth of mental health services in 2014. That assistance is now expected to shrink as a result of healthcare reforms under President Trump.
After Republicans have pledged to make some major cuts in federal spending, there is still hope out there that agencies like the Substance Abuse and Mental Health Services Administration (SAMHSA) would not see their funding severed. This would potentially be another devastating blow to the efforts already in place to battle addiction in America. Will President Trump defend these programs to help addicts?
What Will Help?
Some of the ideas this administration mentions do have some hope behind them. My opinion, we might want to hear more about the expansion of treatment options and access to life-saving resources. The strong focus on border control and President Trump’s cries for “law and order” and aggressive investigations sound extremely reminiscent of the War on Drugs that failed so many families and people suffering.
As the former drug czar Michael Botticelli stated,
“Any drug policy that’s going to be effective has got to be based on science and research,”
So President Trump has his work cut out for him, but some still say we need to see more being done with healthcare and providing resources. More advocates want to hear plans on healing people; on how we plan to save lives. Assure people by taking real action to show they will not be without insurance or treatment.
So this does not mean to say the President’s plans are not good. Essentially, we just want to hear more about them besides borders. If his plans do involve expanding current resources, and if the ACA is effectively replaced; if we see adequate funding appropriated for the CARA and if we make this about more than just immigrants and law enforcement, then the plan could make a difference. So far only time will tell.
Drug abuse and addiction is a devastating and deadly disease, and providing effective and compassionate treatment makes a lifelong difference. If you or someone you love is struggling with substance abuse or addiction, think about who you want to be working with to find a real solution. Please call toll-free now.
CALL NOW 1-800-951-6135
(This content is being used for illustrative purposes only; any person depicted in the content is a model)
Author: Shernide Delva
Last month, Health and Human Services Secretary Sylvia M. Burwell announced an initiative to provide $685 million in awards to 39 national and regional healthcare networks and supporting organizations. Have you ever been in a hospital where you felt more like a number than a patient? This initiative wants to address those issues that are affecting our hospitals and health care facilities nationwide. The initiative called the Transforming Clinical Practice works as a part of the Affordable Care Act.
The goal is to equip more than 140,000 clinicians with tools and support needed to mainly:
- Improve Quality of Care
- Increase Patients’ Access to Information
- Reduce Costs
The $685 million will be one of the largest federal investments given to support clinicians and will impact all 50 states through collaborative and peer-based learning networks. Secretary Burwell, elaborated by saying:
“These awards will give patients more of the information they need to make informed decisions about their care and give clinicians access to information and support to improve care coordination and quality outcomes.”
Overall, the goal is to move toward a wellness-based approach to managing care. For example, The American Board of Family Medicine will work with more than 25,000 family physicians serving 50 million or more patients to help clinicians and patients navigate the changing healthcare system and reduce disparities in healthcare.
The efforts of the initiative will accomplish the following and more:
- Help providers give patients better tools for communication
- Provide dedicated coaches to better manage chronic disease and offer preventive care
- Offer real-time notification alerts for clinicians caring for high-risk patients
- Improve screening and treatment of mental health and substance abuse across multiple care settings
- Centralize data reporting with technical assistance
- Promote patient, provider and community engagement
In the past, patients felt like nothing more than a number. The care in hospitals was becoming less personal and more data-based. As a result, this initiative hopes to accomplish fostering new levels of coordination, continuity and integration of care. The ultimate goal is to transition from volume-driven system to value-based, patient centered healthcare services.
Secretary Burwell released the awards in conjunction with a round-table discussion with Members of Congress and health care leaders. They discussed ways to transform our nation’s health care system into a system that rewards value over volume.
During the conference, it was announced that part of the funds would support 29 medical group practices, regional health care systems, and regional extension centers in offering peer-to-peer support to primary and specialty physicians, nurse practitioners, physician assistants, clinical pharmacists, and their practices.
In addition, $27 million would be given to 10 national organizations and health care professional associations in order to:
- Align clinical practice guidelines across multiple medical specialties so there is uniformity.
- Offer Continuing Medical Education credit to clinicians to support transformation efforts
- Share best practices and provide technical assistance and coaching to their members; discuss alternative payment methods.
- Provide educational materials and access to registry data information and training on how to use the data to improve care.
These awards come as part of a comprehensive strategy advanced by the Affordable Care Act to build upon successful models and programs such as the Hospital Value-Based Purchasing Organization Program, Partnership for Patients with Hospital Engagement Networks, and Accountable Care Organizations.
Americans need a health care system that delivers the right care, at the right time, and at a cost that is reasonable and easy to understand. Now patients will be able to reply on their doctors and health care team to provide them the quality of care they need. Such a system will result in fewer unnecessary hospital admissions and readmission, fewer healthcare-associated infections, and reduced patient harm, and will show continuous improvement in quality outcomes and cost efficiency.
The more efficient our health care system the better chance more people will be taken care of properly. As more and more people suffer from addiction, improving access to medical facilities becomes a more important issue. If you or someone you love is struggling with substance abuse or addiction, please call toll free 1-561-221-1125.
Author: Justin Mckibben
As we come closer to 2016 and the next presidential election, there are already talks of how the candidates will determine their strategies and focus points on the campaign trail. Former Secretary of State and former First Lady Hillary Clinton has outlined in the last week her own crusade the same way at just about every event she has attended so far, and it seems that what has been labeled the “silent epidemic” of addiction is a key point for her.
When listing her “four big fights”, Clinton mentioned:
- Rebuilding the economy
- Strengthening families
- Stripping dysfunction from government
- Protecting the country from security threats
Included in that outline mental health and substance abuse are not frequently discussed in presidential politics, however it seems that these subjects keep being brought to the forefront of Clinton’s attention, and she has not made light of the importance of addressing it.
The Hot Topic
Last week Clinton heard it brought up in Iowa in Council Bluffs, and in Davenport. Then again this past Monday the thought came up. Clinton spoke to voters at a “round table” discussion at Whitney Brother’s furniture manufacturer in the key primary state of New Hampshire, and the Democratic presidential hopeful promised to make mental health and substance abuse a large part of campaign. Hillary described it as more of a national concern instead of an issue in singled out communities and said,
“I think a lot of people are thinking, Well, that’s somebody else’s problem. That’s not my problem. And indeed, it is all of our problem. This is not something we can just brush under the rug and wish it would go away.”
Several participants at the panel-like discussion at expressed to Clinton that they viewed mental health problems, including substance abuse, as a leading concern. Pam Livengood, an assembler at Whitney Brothers, raised the issue and defined it as a “growing drug problem” in the area, citing a personal experience with a struggling family member and saying,
“There are very limited resources here. And we’d like to see something in that respect. Do you have any further ideas?”
This discussion attended by about a dozen local Democrats was meant to concentrate on the first of Clinton’s “four big fights”: the economy.
However she made a shift in content after Livengood brought up mental health, and spent a considerable chunk of time discussing the issue with several other panelists. Clinton answered with,
“Well, I do actually. I am really concerned, because, Pam, what you just told me, I’m hearing from a lot of different people.”
Clinton went on to mention the town of Austin, Indiana and the fact that drug use and sharing of dirty needles in that area has led to an HIV outbreak, and concluding that more resources should be spent on drug treatment. She told reporters that she wants the people to know she is listening, and the more she travels the more the issue comes up, so it must be taken into serious consideration.
Clinton’s Continued Campaign
Clinton only announced her campaign for president just over a week ago, but she seems to be on the offensive. Hillary seems to have some idea of how the dynamics of addiction has changed, noting that addiction persist as an increasing problem that has become less visible, which is why she refers to it as a “quite epidemic”. She added that treatment programs have seen steady cutbacks instead of new and improved support.
That being said, Clinton has made a point to show people that she is acknowledging their concerns. At a house party in Claremont, Clinton later that same Monday she told a crowd of about 50 people how much Livengood’s comment had reverberated in her mind, and how if she were just to read briefing books and focusing on her competition instead of on the issues, she would never have heard that clear message.
The roundtables are basically the main event format at this stage of the campaign game, so the topics put forth here may inform policies Clinton introduces later this year. So far she has praised the measure in the Affordable Care Act that requires most health insurance plans to cover mental health and substance services, but she said lawmakers have to do more and called for a “concerted policy” at all levels local, state, and national across the public and private sectors.
Other politicians have noted the importance of this issue, and it should be noted for voters that thus far it seems Clinton is more than willing to acknowledge the issue as an integral concern for most people in America. In the aftermath of what many people consider as a failed war on drugs, and in light of the recent spikes in heroin abuse and the mounting issue with overdose deaths, Clinton has done well to take the voters comments and questions into contemplation. Hopefully as this campaign continues we will hear more about what new ideas and initiatives she brings to the table.
While politicians and reformers fight to bring an end to the addiction and substance abuse problem running rampant in America, we see a lot changing in regards to drug policy, and the treatment of addicts. Maybe the future holds more innovation, but for now it takes some hope and action. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135
(This content is being used for illustrative purposes only; any person depicted in the content is a model)
Author: Justin Mckibben
One terrible reality of drug or alcohol addiction is that not everyone who suffers from this disease survives it. Not everyone who needs treatment will get treatment, and not everyone who gets treatment will stay on the right path after leaving an inpatient program.
Every single day men and women around the world are losing their lives to this insidious and devastating disease, and many in the field of alcoholism and addiction treatment work tirelessly to improve on available resources and policies. Now one family is doing their best to make a push for better treatment policies as well.
After losing their 24 year old son to a deadly heroin overdose, one Pennsylvania family started the Anthony’s Act petition. The Anthony’s Act petition is named after the young man who tragically passed, and the family is rallying for supporters in hopes of increasing the effectiveness of in-patient drug treatment programs, more specifically by pushing for longer periods of inpatient treatment to allow the maximum benefit.
On May 31, Valerie and Cris Fiore lost their son Anthony to a heroin overdose. Anthony had been in and out of several rehabs, but continued to struggle to stay clean for any considerable amount of time. However, the problems only got worse because the Affordable Care Act only provides a 30-day maximum treatment program. The family believes that because his time at inpatient was always cut so short he didn’t have enough time to recover.
In honor of their son, as well as other addicts who are struggling with drugs and alcohol, the Fiore family has started Anthony’s Act as a petition aimed at increasing the minimum length of inpatient drug and alcohol treatment programs to 90 days. Anthony’s father Cris Fiore said,
“One of the things that is so important about inpatient treatment that’s so important is it gets you out of that environment. You’re some place safe, secure and away from the things that were a bad part of your life before.”
While a lot of concern is centered on the idea that the drastic increase would come with a pretty expensive price tag, Anthony’s Act is confident that there could be as much as a 12 to 1 return on that financial investment. Anthony’s Act states that by attending an effective treatment for an extended period of 90 days, it would not only reduce the risk of a patients relapse by up to 73%, but it would also decrease the amount of drug-related accidents, including overdoses and deaths. Cris Fiore went on to say,
“The way the system works right now is 30 days or less,” he added. “And people are just going through rehab after rehab after rehab. It’s not working. Anthony…every time he came home he used that night.”
So far the Fiore family has already obtained over half of their target for the petition of reaching 10,000 signatures. The family has even encouraged supporters to tell their representatives that these changes need to be made, and that they should insist the Affordable Care Act must be amended to provide for a minimum of 90 days inpatient drug or alcohol treatment, while pushing for up to a maximum of 180 days per year. The family also asserts treatment should only be given at a facility certified to provide this level of care by the Secretary of Health of the state in which it is located.
While it is unclear how this petition will eventually inspire lawmakers and what compromises will be made to support these stipulations, it should be noted that treatment is effective in many cases, but there should typically be an aftercare program and continued recovery after treatment. Recovery from drugs and alcohol is not a quick fix or a cure, recovery is a life-style that most addicts and alcoholics have to work consistently for lasting sobriety.
It’s admirable that people are fighting for the best treatment possible through the Affordable Care Act, but people should also be aware that no matter how long you are in an inpatient program, you still want to work on your sobriety every day. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135