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ASHINGTON — Health advocates on Friday used the first meeting of President Trump’s commission on the opioid crisis to criticize a bill that would slash future Medicaid spending and deregulate the health insurance market, arguing that the legislation would undermine whatever progress the panel could make.

“Medicaid is the largest national payer for addiction and mental health treatment,” said Dr. Joe Parks, the medical director for the National Council for Behavioral Health. “Since the majority of increased opiate deaths and suicide occur in young and middle-aged adults, which is the [Medicaid] expansion population, the Medicaid expansions must be maintained and completed.”

His audience at the first meeting of the President’s Commission on Combating Drug Addiction and the Opioid Crisis, chaired by New Jersey Gov. Chris Christie, included Health and Human Services Secretary Tom Price, top White House advisers Kellyanne Conway and Jared Kushner, and Secretary of Veterans Affairs David Shulkin.

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A pending bill in the Senate is expected to call for slashing federal Medicaid funding and rolling back expansions put into place in recent years by the Affordable Care Act. A version of the bill passed by the House would reduce planned Medicaid spending by $880 billion over the next decade.

“Medicaid, essential health benefits, parity, parity, parity,” said Gary Mendell, the CEO of the addiction-focused nonprofit Shatterproof, referring to Medicaid cuts proposed in Trump’s budget and by pending legislation to repeal elements of the Affordable Care Act, including regulations mandating which basic aspects of health care insurers must cover. “That category cannot be underemphasized.”

Democratic legislators in recent weeks have highlighted the gap that would be left by a Medicaid cut. Data show that Medicaid-eligible patients in expansion states pay less in out-of-pocket costs for addiction treatment. Medicaid programs also account for roughly one-quarter of annual payments for buprenorphine, an opioid-based painkiller used in medication-assisted addiction treatment.

At Friday’s meeting, North Carolina Gov. Roy Cooper, a Democrat and a member of the opioid commission, also emphasized the importance of Medicaid in addressing the nation’s epidemic.

“We’re kidding ourselves if we don’t think that what is happening over in Congress regarding issues of health care matters to this issue,” he said, later citing Medicaid specifically. “If we make it harder and more expensive for people to get health care coverage, it’s going to make this crisis worse.”

There was consensus on at least some issues related to medical treatment during the session. Chief among them was that naloxone, an overdose-reversal drug, must be made widely available to communities and law enforcement agencies nationwide.

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Cooper was also receptive to a point made by Dr. Kelly Clark of the American Society of Addiction Medicine, who maintained that despite Medicaid’s importance to addiction treatment it does not always spend its dollars efficiently, especially with regard to the “substantial” number of reimbursements issued for detoxification treatment.

“I can tell you that typically, the utilization of inpatient detoxification and the 28-day manualized rehabilitation is not evidence-based care,” she said. “We know that detoxification is not considered treatment by ACM for opioid addiction. We’re using a lot of expensive care in inpatient environments and not the ongoing care that we need to do for chronic brain disease treatment. It’s substantial.”

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  • It looks like just like the CDC this committee is made largely of people who are already biased against opiates and no one there to represent the chronic pain patients who are taking their lives at a rate faster than the OD”s in this country. Why is it that you can let 100 million suffer to save 50,000? This does not make sense and it is inhumane to let people suffer needlessly. Those who are ill did not ask to become ill while addicts CHOSE to do those drugs. The numbers just do not add up to an epidemic so stop this fake war on pain patients. We are 100 million strong and WE VOTE TOO! Can you imagine giving ALL diabetics the same amount of insulin no matter their numbers?, this is EXACTLY what you are doing to people in pain. We are not being treated as individuals with individual health issues but as criminals even though we have done NOTHING wrong! So all of you politicians who want to play Dr and pt your nose in our health care decisions should expect us out in force when your seat comes up for re-election. Your practicing medicine without a license and the CDC used biased data to come up with their addiction industry saving guidelines,…Yes all you have ot do is follow the money to see whats going on here and it has NOTHING to do with OD rates!

    • Exactly, my wife lives with Stage 4 cancer and sees a reputable pain management specialist for hydromorphone (morphine.) Since Florida passed their new “pill mill” law a couple of years ago, now she is subject to random drug tests to make sure she’s taking her meds & not selling them on the street. Seriously? Like a 58 y/o middle class mom & former kindergarten teacher and Stage 4 cancer patient would be selling her pain meds on some street corner?
      These drug tests get billed to our insurance for about $400 a pop and about twice a year. Thankfully, we have decent insurance so only pay about 15% so long as we stay in network. Thanks a lot, AG Pam Bondi & Gov Rick Scott. For nothing! I think we should follow the money on this issue … all this new MedicAid funds they are proposing for “treatment” … well, who owns these “treatment” centers and who do they make campaign & party donations to. Those places have to be some serious cash-cows. That’s what I’d like to see some investigative journalists looking into.

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