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people living with substance use disorder will lose some or all of their health insurance coverage if Obamacare is repealed.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
Sometimes new policy can be good. Sometimes, not so much.
The opiate epidemic in America has hit some states with staggering rates of overdose and death. The paralyzing truth gripping the nation today is that more people are dying from drug overdose than homicides and car crashes. Heroin, fentanyl and prescription painkillers collectively decimate entire communities. People from all over are starting to push officials and lawmakers for more progressive and effective solutions.
Addiction has led to an overdose outbreak that shakes the country to the core, everywhere. Now, Florida lawmakers are pushing for new legislation to try and protect and serve those who suffer from an overdose. One of the first bills on the 2017 agenda is one that hopes to change how law enforcement treats overdose victims.
Although, another bill is trying to turn things in a very different direction.
Florida HB 61 Bill
Florida Representative Larry Lee, a Democrat from Port St. Lucie, has filed a proposal titled HB 61. If approved, this piece of reform would require several new policies for healthcare providers, starting with hospitals.
- It would require hospitals to screen overdose victims to determine the need for additional health care services
- Prohibits hospitals from discharging overdose patients to a detox or treatment facility until stabilized
- Requires attending physician to attempt contact with patients primary care physician, or other treatment providers, who prescribe controlled substances to notify them of overdose
- Requires hospital to inform medical director of treatment center (if patient is currently in treatment) of the overdose
- Hospital must inform overdose victim’s family or emergency contact of overdose
- Must inform contacts what drugs they suspect to have caused overdose
- Attending physician must provide list of drug treatment providers and information about Florida’s Marchman act and Backer act in case the family or contact wishes to seek legal action to protect the addict
The Big Change in HB 61
Lastly, what is probably the most progressive part of this legislation, is the HB 61 bill would prohibit criminal charges from police officers and prosecutors against the overdose victim for possession of any drugs found on them during the incident.
This final aspect of HB 61 this writer thinks is a big deal, because from personal experience I have seen and heard many stories of individuals not calling for help in the event of an overdose out of fear of prosecution. In some cases people actually die because of the fear of criminal punishment. Adding this kind of measure to the bill is an attempt at eliminating the loss of life due to fear of discrimination. Even if it is not a perfect system, this kind of reform takes first responders and law enforcement a step closer to dealing with addicts who are fighting a fatal illness like sick people instead of criminals.
Florida SB 150 Bill Attacks Fentanyl
From across the aisle we see another push from Republican Senator Greg Steube from Sarasota. The question is, will this push go in the right direction? On December 12, he introduced bill SB 150. This is set to be a direct attack on fentanyl.
For those who are not yet familiar, fentanyl is an incredibly powerful, and lethal, opioid painkiller. It’s medical use is to sedate surgical patients and relieve chronic pain. However, being several times more powerful than heroin, it has crept into the illicit drug trade in various parts of the country. And with its arrival also came a horrifying increase in overdose and death.
This proposal means to make 4 grams or more of fentanyl a first-degree felony through:
November 20, the Palm Beach Post released an analysis of people who died in 2015 from heroin-related overdoses. Out of the 216 individuals profiled in this report, 42% of the cases were found to involve fentanyl. So of course, with Steube coming from a district hit particularly hard by the opiate epidemic, it is logical to want to do everything you can to cut the flow of fentanyl off.
Yet, some say that this kind of strategy is too close to the concept of mandatory minimums.
Is SB 150 Too Close to Mandatory Minimums?
For those who need more clarification, mandatory minimum sentencing laws were a “one-size-fits-all” strategy implemented originally back in 1951 against marijuana, then repealed in the 1970s, and refined in 1986. In 1973, New York State enacted mandatory minimums of 15 years to life for possession of more than 4 ounces of any hard drug.
The idea is that regardless of the individual or the circumstances that a certain crime will have an inflexible punishment across the board. Ever since their introduction, criminal justice advocates have fought these laws, and they have always been surrounded by debate and controversy.
Essentially, some are already saying that SB 150 will ruthlessly make addicts into victims of the already overpopulated prison system. To be clear and fair- the bill does not seem to directly require a specific prison sentence like mandatory minimums, but it’s similar in that it treats every issue related to fentanyl the same.
The issue has already been argued time and time again that non-violent low-level drug offenders have spent excessive amounts of time in prison for possession of a substance. In some cases, an individual will do more time behind bars for possessing a large quantity of drugs than someone who has actually killed someone. Some have come to the conclusion that this tactic just doesn’t work.
The fear with SB 150 is not about the manufacturers or the dealers as much as it is for the consumers. Sometimes individuals purchase drugs on the street believing it to be heroin or another substance without even knowing there is fentanyl in it. So this bill would make first-degree felons out of desperate addicts?
What is Right?
The big question we all face at the end of the day is- what is the right thing to do? How is the best way to handle something that feels so utterly out of hand?
Well, it would seem like its time to finally let go of the archaic stigma. More states and law enforcement officials are turning to compassionate and supportive progress. Many places in America are starting to do everything they can to help people struggling with addiction to find help before it is too late. So why move backwards?
In my opinion, strictly based on what has been presented so far, SB 150 seems dangerous. There are countless advocates out there who say that intensifying the punishment is not how you deter the crime. Especially when it comes to addiction, because this kind of method still suggests it is a moral failing and not a psychological and physical illness.
HB 61 seems to be trying to call health care providers to action and add more accountability on the front lines in the fight against the overdose outbreak. At the same time it seems to move in the opposite direction of SB 150 by trying to limit the persecution of addicts. HB 61 makes more room to help preserve life and offer treatment and solutions. By now we should already know, the solution isn’t a War on Drugs, it is community and compassion.
These are some of the initial responses to recommendations recently made by the grand jury. Every day there are countless people suffering. And every day there are countless more recovering and fighting to help others recover. If you or someone you love is struggling, please call toll-free now. We want to help. You are not alone.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
By now everyone who is paying any attention to politics has heard about the Republican presidential nominee Donald Trump. And if you have heard of Trump, you have heard of his infamous wall. Yes, THE WALL. The ‘life-saving, world changing, country resurrecting’ wall. Let us just call it THE GREAT WALL OF ‘MERICA! Because, it will of course be greater than that shabby wall some people in China seem to think is so great.
I digress… It appears that this wall will do more than inspire racial division. Apparently THE WALL will also solve the opioid epidemic in America.
Yes… that’s what he said…
Building a wall between the United States and Mexico, according to his recent statements, will be the best solution to this issue.
The Wall against Opiates
This astonishing revelation was made during a town hall meeting in Columbus, Ohio on Monday where Trump was doing a little Q&A with the curious citizens of the capitol city in the Buckeye State. After an audience member asked him to “cut off the source” of heroin, Trump stated:
“We’re not gonna let this crap come into our country and poison our youth and poison our people, and it comes in mostly from the southern border,”
Granted, since the 1990’s statistically the primary supplier of heroin to North America has been Latin America and Mexican cartels. So this whole concept of blocking the flow of heroin into the country isn’t entirely baseless. However, Mexico is definitely not the only way heroin gets into America. The source is also definitely not the only element to the outbreak. Let us focus on his thought process just to point out where else he speaks with a heavy stigma accent.
Heroin Problem Place?
To elaborate on his plan, Trump talked about campaigning in New Hampshire. His time there helped him realize the extent of the heroin epidemic. Voters in New Hampshire town hall meetings consistently said that their biggest concern was heroin, which surprised Trump. The next thing he had to say was unsettling in a different context.
“My first victory was New Hampshire, which is a beautiful, beautiful place … This doesn’t look like it’s a heroin like problem type place,”
So wait… he means to say that only bad parts of town or less “beautiful” places are where he expects to find heroin addiction? Since he didn’t elaborate on where he would expect to see it, does this imply that Ohio is a place not pretty enough to be off Trump’s “heroin problem place” check list?
Ok, maybe those aren’t his words either. Still, thinking only certain people in certain places have a heroin problem shows he’s out of touch with the epidemic. Not to mention how disconnected this kind of thinking is from the truth about addiction.
While Trump was explaining his plan to wall off the drug problem in America, he said,
“They say, Mr. Trump, it is flowing across our southern border.”
But maybe… just maybe the New Hampshire residents were referring to the border between New Hampshire and Massachusetts. Drugs regularly travel in bulk via interstate highways into New Hampshire and the rest of New England from this area. So perhaps Mexico is way more south than New Hampshire is saying we should be looking.
WALL is LIFE
What Trump did fail to acknowledge is that many powerful opioids that end up on the black market, like fentanyl, originate from Chinese suppliers. So even if we make a huge dent in the heroin supply from Mexico, there are still plenty of countries that have been sending it over for years.
Also, Trump should note the accessibility of prescription drugs is a major driving factor for the opioid crisis. He didn’t, but he should. To have a comprehensive plan, you absolutely have to include addressing the Big Pharma companies involved in opiate medication production.
Trump did finally acknowledge the need for treatment. This is the best thing to come out of the discussion, because he did admit,
“It’s very hard to get out of that addiction, of heroin. We’re gonna work with them, we’re gonna spend the money, we’re gonna get that habit broken.”
This claim at least notes the vital need for treatment options, but lacks any structure or outline on how to address it. Any complete idea on how to defeat the opiate epidemic should include education, intervention and innovations for addiction treatment. But it seems Mr. Trump is more concerned with the U.S.-Mexico border.
Addiction treatment, education and prevention should not be cliff-notes to a drug policy centered on a grandiose design for this wall that is prophesized to “make America great again” by keeping the “bad people” out. It should be centered on the concept of compassion and awareness- two things that, like I pointed out earlier, Trump seems to be in short supply of concerning addiction.
I’ve said it before… the future of our nation should have no room for stigma, we need leaders who are willing to serve the interest of every American. Drug abuse and addiction is a devastating and deadly disease, and more needs to be done to help people besides blaming someone. 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. If you are looking for a way to get your life back, please call toll-free 1-800-951-6135
Author: Justin Mckibben
Back in March we talked about the Comprehensive Addiction and Recovery Act and how Republicans had been less than willing to vote for additional funds to be added to the legislation. In the face of an overwhelming outbreak of heroin and opiate addiction some would say it still falls short. However, as of Wednesday the Senate will advance the legislation forward.
The Comprehensive Addiction and Recovery Act (CARA) is a critical piece of policy for fighting addiction in America. While it may still be an imperfect reform, it is still something to work with. Thankfully, life is about progress not perfection.
A Victory for Fighting Addiction
Some of the primary purposes of the Comprehensive Addiction and Recovery Act are to:
The whole intention, as we have stated before, was to formally authorize the federal government to utilize a more compassionate response system in address addiction. This would replace relying on prison and a cycle of punishment that only feeds into the problems so closely connected to drug abuse such as poverty. The bill is a product of:
- Republican Senator Rob Portman of Ohio
- Democratic Senator Sheldon Whitehouse from Rhode Island
Despite concerns over funding, Democrats in the Senate decided not to block the measure. The Comprehensive Addiction and Recovery Act passed with a rousing 90 votes for and only 2 against.
Majority Leader Mitch McConnell, a Republican from Kentucky, stated:
“By increasing prevention, treatment, recovery and law enforcement tools, CARA can help prevent more people from struggling with addiction to begin with, and it can help foster long-term healing for those already struggling with addiction,”
It is more than logical to attack the issue with addiction on the back-end while also address the root causes. Hopefully this new legislation can follow through.
Money Makers Make It
As far as objections go, there were plenty despite the Democrats being willing to pass the act anyway. When the Comprehensive Addiction and Recovery Act had pushed through the House last week in a nearly unanimous decision there was already concern. Democrats had offered up and amendment to provide $920 million to fighting opioid abuse. Republicans shot this proposal down. The emergency funding provision would have allocated additional financial backing for various innovative programs including:
- $230 million to law enforcement initiatives, including treatment alternatives to incarceration
- $10 million would have gone to state and local law enforcement units that oversee communities with high levels of drug use
- $300 million for state programs focused on prevention, treatment and recovery, and for improving treatment for pregnant and postpartum women dealing with heroin or opioid addiction.
Consider all the work that needs to be done in order to support these initiatives. Why doesn’t more money make it through? Regardless, Democrats recognized the severity of the situation and voted to pass the bill. During the floor debate in the Senate it was noted that more money is needed to provide support for:
- Mental health workers
- Law enforcement
- Addiction beds at addiction facilities
Still, there is some hope for more funding. Republicans have assured they will work to include additional funding in 2017 appropriations legislation. New York Democratic Senator Chuck Schumer stated,
“Until we pass the increase in resources for both law enforcement and treatment, we cannot say Congress has done what is necessary to solve and fight the opioid crisis,”
This is absolutely true. Without putting your money where your mouth is it will be far more difficult to fight this fight. Providing lasting and diverse support for addiction treatment means investing in it. With the prominence of addiction in this country, it is an investment in our own future.
Reforms aimed at addressing addiction and supporting recovery are no walk in the park, but the fact that addiction is being viewed as the health issue it is, not the moral failing people once assumed it was, shows progress. Hopefully support for addiction treatment will grow and more lives will be saved. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135
On Tuesday, President Barack Obama took a firm stand against the drug that kills over 28,000 Americans a year. At the National Rx Drug Abuse and Heroin Summit in Atlanta, Georgia, President Obama told nearly 2,000 policymakers, professionals and parents, that the nation must provide more treatment for people addicted to opioids and re-frame the addiction problem through the lens of public health.
Obama stated that the most important thing the nation can do for the opioid epidemic is reduce the demand for the drugs through providing treatment and treating addiction as an illness, not a criminal issue.
“Part of what has made it difficult to emphasize treatment over criminal justice system has to do with the fact that the populations affected in the past were … stereotypically identify as poor and minority,” he said. “And as a consequence, the thinking was it is often a character flaw in those individuals who live in those communities. … One of the things that’s changed … is a recognition that this reaches everybody.”
Few politicians have mentioned the association using drugs had with lower income minority communities. Obama was outright in elaborating on how little was done in the past to help communities stifled by drug addiction due to many believing it was a “character flaw,” or simply a choice choice. Now, that the addiction epidemic has spread to the middle class and affluent neighborhoods, the public has finally opened their eyes to the fact that addiction really is a disease.
Across the United States, more Americans die each year from drug overdoses than from motor vehicle crashes. In 2014, there were 47,055 deaths from drug overdoses, the highest number on record. Most of these overdoses, close to 28,000 were due to prescription painkillers and heroin.
At the Summit, President Obama announced several proposals aimed at increasing access to medication-assisted treatment (MAT) for opioid addiction. For example, physicians are limited to providing drugs like Suboxone and buprenorphine to only 100 patients. Under the new proposed rule issued by the Department of Health and Human Services (HHS), that number will double to 200. Raising the patient limit will increase access and allow doctors to treat more people. Opioid agonist medications, like Suboxone and buprenorphine, have been shown to decrease overdose deaths, reduce transmission of infectious diseases, and reduce criminal activity.
Not too long ago, President Obama proposed $1.1 billion in new funding to ensure every American will have access to opioid use disorder treatment. Then in March, the administration announced it would dedicate $94 million to fund 271 community health centers in order to increase and improve substance abuse treatment.
“My job is to promote the safety, the health, the prosperity of the American people,” said the president in his remarks. “When you look at the staggering statistics in terms of lives lost, productivity impacted, costs to communities, but most importantly, cost to families from this epidemic of opioids abuse, it has to be something that is right up there at the top of our radar screen.”
Another key strategy is establishing a Mental Health and Substance Use Disorder Parity Task Force. The objectives of this task force will be to:
- Increase access those in need have to substance abuse disorder treatment
- Promote compliance with best practices for mental health and substance use disorder parity implementation
- Develop agency guidance as needed to address the ongoing opioid epidemic.
The president also elaborated on the need to address the opioid problem in rural communities. On Monday, The Department of Agriculture launched a $1.4 million Rural Health and Safety Education Grant Program to address this very problem.
Also, on the agenda was addressing needle exchange programs. Last year, Obama lifted a ban on these programs, allowing certain communities to use federal funding to support them. In the past, laws stated needle exchange programs could not be federally funded.
“When you look at the science, there’s no evidence that because of a syringe exchange program or Naloxone, that that is thereby an incentive for people to get addicted to drugs. That’s not the dynamic that’s taking place,” said the president during the panel discussion at the Rx Summit.
Overdoses are at an all-time high and prescription drug dependency needs to be addressed. At this time, we need to do whatever it takes to tackle the horrifying statistics that continue to get worse. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.