The House Republican proposal to replace the Affordable Care Act would strip away what advocates say is essential coverage for drug addiction treatment as the number of people dying from opiate overdoses is skyrocketing nationwide, the Washington Post reports. Beginning in 2020, the plan would eliminate an Affordable Care Act requirement that Medicaid cover basic mental-health and addiction services in states that expanded it, allowing them to decide whether to include those benefits in Medicaid plans. The proposal would roll back the Medicaid expansion under the act, which would affect many states bearing the brunt of the opiate crisis, including Ohio, Kentucky and West Virginia. Thirty-one states and the District of Columbia expanded Medicaid under ACA.
“Taken as a whole, it is a major retreat from the effort to save lives in the opiate epidemic,” said Joshua Sharfstein of Johns Hopkins Medical School. Advocates and others stress that mental-health disorders sometimes fuel drug addiction, making both benefits essential to combating the opioid crisis. Nearly 1.3 million people get treatment for mental-health and substance abuse disorders under the Medicaid expansion, estimate health care economists Richard G. Frank of the Harvard Medical School and Sherry Glied of New York University. House Republicans confirmed the benefit cuts during a meeting of the House Energy and Commerce Committee on Wednesday. Republicans argue that the change would give states additional flexibility in coverage decisions, and believe they would continue to provide addiction and mental-health coverage to Medicaid recipients if needed.