Health care replacement bill could be detrimental to opioid epidemic

March 15--Under the Republicans' replacement plan for the Affordable Care Act, an estimated 24 million Americans will lose health insurance, including many who are suffering from addiction.

More than 20 million Americans had a substance use disorder in 2015 -- 2 million cases involved prescription pain relievers and 591,000 involved heroin.

A recent study by Harvard Medical School and New York University said more than 214,000 West Virginians suffering from addiction or mental illness would lose access to health care services if the Affordable Care Act (also known as Obamacare) is repealed.

Michael Botticelli, former director of the White House Office of National Drug Control Policy, said during a press call Tuesday the U.S. is in the midst of one of the greatest public health crises.

"There are devastating consequences all across the country," Botticelli said, noting the significant increases in HIV and hepatitis associated with intravenous drug use. "We have to ensure people have adequate and timely access to addiction care."

The ACA allowed many individuals with substance use disorders to gain access to treatment and other health care services, Botticelli said, especially through Medicaid expansion.

More than 170,000 West Virginians gained coverage since January 2014 because of the Medicaid expansion, according to West Virginians for Affordable Health Care.

Botticelli said untreated addiction has other consequences aside from increased morality rates.

"Untreated addiction drives up crime, and presents public safety risk... It also drives up health care costs and other costs such as the foster care system."

He said the ACA provided a stable base of funding for treatment providers to operate and even expand services. Under the new plan, however, no such safety net is in place.

"Providers will be impacted from a financial standpoint, losing Medicaid billing and possibly private insurance."

He said this especially threatens rural parts of the country, like West Virginia, where many residents don't have a treatment provider near them.

----Dr. Richard Frank, a Harvard Medical School professor of health economics, said between 2014 and 2015, there was an increase of 15 percent in the rate of opioid deaths in the country.

"Opioid use disorder is a disorder that's particularly prevalent in lower income populations," Frank said.

He said opioid use disorder is 40 percent more common in populations with incomes under 200 percent of the federal poverty level.

Frank also noted the low percentage of people who get treatment for opioid use disorder -- roughly 11 percent.

He said there was a growth in the treatment rate since 2013, when the ACA made health care available to more Americans. The American Health Care Act (Trumpcare), however, pulls resources away from those who received coverage under Medicaid expansion.

"When states feel under financial pressure, they revert to a way of operating that preceded the ACA."

Frank said states will either have to make up that money or limit access to treatment. Strict limits will likely be imposed on medication-assisted treatment as well.

Spending patterns under Trumpcare will grow at a rate of 3 to 4 percent per year, Frank said, which does not match the 15.6 percent growth rate of the opioid epidemic.

----Gary Mendell, founder, chairman and CEO of Shatterproof, said this public health crisis should be taken as seriously by the government as Ebola and Zika.

"It's spreading like crazy, like an infectious disease."

More important than the numbers though, Mendell said, are the faces behind the statistics: "Every one death is a father's son, a mother's daughter."

Mendell lost his son to addiction. He said he was glad his son didn't have to worry about insurance coverage as he battled addiction, but he could not imagine having gone through the situation without it.

-- Email: [email protected] and follow on Twitter @WendyHoldren

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