MSNBC’s Chris Hayes hosted an event in McDowell County, West Virginia, yesterday — the event will air tonight — in which he asked attendees how many of them have lost someone due to opioid addiction. By some accounts, roughly three-fourths of the audience raised their hands.It was a striking reminder about the toll the nation’s addiction crisis can take on a community. It also raised anew concerns about Donald Trump’s budget plans, which would make a horrible situation vastly worse. The Washington Post reported the other day:
The 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.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 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.
Joshua Sharfstein, associate dean at Johns Hopkins Bloomberg School of Public Health Advocates, told the Post, “Taken as a whole, [the Republican health care plan] is a major retreat from the effort to save lives in the opiate epidemic.”The fact that Donald Trump spent months assuring voters that he’d take the exact opposite course adds to the severity of the betrayal.Less than a month before Election Day, for example, the Republican delivered a big speech in New Hampshire, outlining his “plan to end [the] opioid epidemic in America.” The speech was long on attacks on Hillary Clinton — whom Trump mentioned 15 times in relatively brief remarks — and short on policy specifics, though the then-GOP candidate vowed to “dramatically expand access to treatment slots.”Three months later, in his inaugural address, Trump’s memorable line — his reference to “American carnage” — specifically referenced “drugs that have stolen too many lives and robbed our country of so much unrealized potential.”And yet, here we are, watching Republicans pushing a “Trumpcare” plan that would, according to experts, worsen an existing crisis.Slate‘s Jamelle Bouie explained the other day that Trump has now “committed his administration to the exact opposite of what he’s promised.”
[Medicaid] covers more than 70 million people and is the largest source of funding for behavioral health treatment, like addiction recovery and substance abuse prevention. Indeed, the Affordable Care Act required Medicaid to start paying for all available addiction treatments, beginning in 2014. And in the 31 states that expanded the program under Obamacare, 1.2 million people have gained coverage for substance abuse treatment…. If Trump were serious about fighting opioid addiction, he would at least commit to strengthening the program.Instead, he’s put his weight behind the American Health Care Act,… Not only would the bill phase out the Medicaid expansion, but it would eliminate a host of coverage requirements for insurers, including coverage for drug treatment. Millions of Americans would lose insurance altogether (to pay for lower taxes on high earners) while those still on Medicaid would lose access to help for addiction and substance abuse…. In one swift move, millions of Americans would lose meaningful access to health insurance, which is to say, millions who struggle with addiction will lose the help they need. And this is to say nothing of treatment facilities that rely on federal dollars to operate. Under this bill, they lose out too.
American carnage, indeed.
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Steve Benen is a producer for "The Rachel Maddow Show," the editor of MaddowBlog and an MS NOW political contributor. He's also the bestselling author of "Ministry of Truth: Democracy, Reality, and the Republicans' War on the Recent Past."