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people living with substance use disorder will lose some or all of their health insurance coverage if Obamacare is repealed.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
It is no secret that President Trump has not been exactly consistent with his views of drugs, specifically legalized marijuana. During the course of the campaign for President he flip-flopped a lot on whether or not he would support or oppose legalization. While a wave of marijuana reforms have continued to blossom in several states, it seems those inconsistencies are again cropping up. Now one can only guess what is going to come of the Trump administration and their strategy on marijuana.
Just this Thursday, White House press secretary Sean Spicer came to speak on behalf of the Trump administration. Here he suggested the federal government may soon crack down on recreational marijuana use across the country. Not just as part of the “law-and-order” stance of the plan for the Trump administration, but even in states that have already legalized marijuana for recreational use.
Timeline on Trump’s Back and Forth
So just to give us an idea of how this back and forth goes, we will set a timeline of notable changes in Trump’s attitude toward marijuana.
Back in the early 90s Donald Trump actually stated that he believed the United States should legalize all drugs and use the funds from sales to educate people on the dangers of drug use. During an interview he stated:
“We’re losing badly the war on drugs,” he said. “You have to legalize drugs to win that war. You have to take the profit away from these drug czars.”
Then, during the campaign of 2016 the attitude began to slip and slide at all sides of the spectrum. In June he stated he was adamantly opposed to legalization of marijuana. He still kind-of-sort-of supported medical marijuana at the time. His comments during the June CPAC Conference:
“I say it’s bad. Medical marijuana is another thing, but I think it’s bad, and I feel strongly about it,”
These comments come after a period in which he had stated he was a long-time supporter of marijuana for medical purposes.
During the same campaign, Trump was at a rally outside a casino in Reno, Nevada where he stated the government should use Colorado as a “litmus test” to properly assess the dangers of recreational marijuana. So he went from strongly opposing legalized marijuana, to supporting marijuana reforms, pending further review.
Later, the soon-to-be-President Trump had stated on the campaign trail he would only support marijuana legalization at the state-by-state level, essentially affirming he would allow the states to make up their own mind about how to handle marijuana reform.
Spicer’s comments during this week’s White House press briefing came in response to a question from a local Arkansas reporter. Spicer was asked whether President Donald Trump was OK with Arkansas’ medical marijuana law, which recently approved its regulations by the state’s Medical Marijuana Commission.
Sean Spicer now tells reporters that Trump does approve of medical marijuana use, which could help provide relief to the chronically ill. However, he is now more firmly opposed to recreational use. The notable addition to this stance is when Spicer says,
“There is still a federal law that we need to abide by … when it comes to recreational marijuana and other drugs of that nature,”
It is notable because now not only has President Trump done a more deliberate shift to stand against recreational use, but now the concept of “state-by-state level” seems to be out the window too. Many are outraged, Marijuana Majority founder Tom Angell saying:
“On the campaign trail, President Trump clearly and repeatedly pledged that he would leave decisions on cannabis policy to the states.”
Because the federal government still considers marijuana an illegal drug, these comments indicate they plan on enforcing those rules regardless of any state’s decision.
Obama Era on Marijuana
These changes in policy are almost the exact opposite of every move made by the previous administration to combat the negative impacts of the failed War on Drugs.
Back in 2014 U.S. Congress approved legislation preventing the DEA from carrying out any raids, arrest, or prosecutions of patients using medical marijuana. It blocked law enforcement agencies under the Justice Department from consuming federal dollars in efforts to enforce federal marijuana laws in states that have legalized the use of medicinal marijuana. Under former President Barack Obama, the Department of Justice did not pursue action against states that legalized recreational marijuana use, including:
In fact, the field of politics was shifting back in 2015 when a bipartisan effort was put forth in Congress to block the DEA from using federal funding for aggressively pursuing marijuana in the states where it was legalized.
Trump Administration “Taking Action”
Yet, this week Sean Spicer suggested the Trump administration and the Justice Department will no longer turn a blind eye to those states. In fact, he states it will be “taking action” against these states. Contradicting all the talk of states’ rights and rolling back federal enforcement to attack states who have their own legislations in place.
Even worse, these comments are completely contradicting a stance Sean Spicer announced on a different issue.
Earlier in the briefing, Spicer said federal guidance telling states to allow transgender students to use bathrooms corresponding with their gender identity was a violation of states’ rights. In fact, Spicer had literally just moments before said:
“If a state wants to pass a law or a rule, or if an organization wants to do something in compliance with a state rule, that’s their right,” Spicer said about transgender bathroom use. “But it shouldn’t be the federal government getting in the way of this.”
To recap, the Trump administration is telling us transgender rights should be left up to the states to decide, but those same “states’ rights” do not apply to recreational marijuana use, despite the fact these states have already done their due diligence through democratic process to make these choices.
While Sean Spicer and the Trump administration don’t seem to want to compare those two subjects, Spicer is happy to relate it to another; the opiate epidemic. During the briefing the press secretary actually suggested there was some relation between states’ decisions to legalize marijuana to the opioid crisis.
The question is how is the Trump administration going to take action? Will the DEA raid dispensaries and shut down businesses and imprison business owners who are working in accordance to their state law? Will they be refusing funding to these states or providing some other form of punishment?
The Trump administration is still willing to support medical marijuana, so the people who it helps most may still be OK.
As an advocate for recovery, and as a recovering drug addict, I understand people want to feel the government is doing something to stop the rising rates of addiction. I just think there is a better place to start; education and treatment.
When it comes to the drug problem in America though, we have to address this issue rationally. The legal status of a drug does not make it any less dangerous to those who struggle with addiction. Alcohol and prescription drugs can prove that any day of the week. If we are really focused on trying to fix the problem, how about we start with those industries? The answer to the opiate crisis or general drug problem is probably more education, prevention, treatment and support.
On one hand, one could say it is good that Trump is malleable in his views so he can develop them overtime with more knowledge and reasoning. What do you think? Either way, abusing any substance is a serious issue, whether it is legal or not. If you or someone you love is struggling with substance abuse or addiction, 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