Friday, March 10, 2017

Drug and mental-health treatment in Medicaid expansion would be optional under House plan

House Republicans' replacement for Obamacare would repeal in 2020 the requirement that substance abuse and mental-health care be covered under Medicaid expansion. That could have a disproportionate impact in rural areas, where such services tend to be less accessible already.

"The proposal would also roll back the Medicaid expansion under the act — commonly known as Obamacare — 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 the ACA," report Katie Zezima and Christopher Ingraham of The Washington Post. "Advocates and others stress that mental-health disorders sometimes fuel drug addiction, making both benefits essential to combating the opioid crisis. . . . Republicans on the committee 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."

However, President Trump has vowed to expand drug treatment, and "Several Republican senators expressed concern about removing the benefits. Sens. Rob Portman (Ohio), Shelley Moore Capito (W.Va.), Cory Gardner (Colo.) and Lisa Murkowski (Alaska) sent a letter to Senate Majority Leader Mitch McConnell (R-Ky.), stating that the plan does not 'provide stability and certainty' for individuals and families enrolled in Medicaid expansion programs, or flexibility for states," the Post reports.

The reporters note, "Nearly 1.3 million people receive treatment for mental-health and substance abuse disorders under the Medicaid expansion, according to an estimate by health care economists Richard G. Frank of the Harvard Medical School and Sherry Glied of New York University."

Frank told the Post that dropping addiction treatment services for low-income people is especially harmful, because they are more likely to abuse drugs. "He said Medicaid recipients who are covered for addiction treatment and maintain their coverage through 2020 would not lose the benefit under the GOP proposal. But, he added, because addiction is a chronic-relapse disease, people may get clean, relapse, stop working and need to go back on Medicaid," the Post reports.

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