Washington, DC – Today, Senators sent to President Trump’s desk a package of legislation to address the opioid crisis while the Trump Administration has taken numerous, unprecedented steps to roll back progress in the fight, such as by enacting regulations that restrict Medicaid, upon which four in 10 Americans with opioid use disorder relies, attacking health care coverage for people with opioid use disorder through its lawsuit to end pre-existing conditions protections, and by promoting junk plans that don’t cover mental health care. In response, Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“Okay, President Trump, you want to fight the opioid epidemic? End your administration’s assault on Medicaid and pre-existing conditions. Without doing that, signing this bill is like shutting the stable door after the horses have bolted.”

ADDITIONAL BACKGROUND:

PRESIDENT TRUMP AND HIS REPUBLICAN ALLIES WANT TO ROLL BACK COVERAGE THROUGH MEDICAID, A LIFELINE FOR PEOPLE SUFFERING WITH OPIOID USE DISORDER

  • Republicans Have Repeatedly Taken Aim At Medicaid. The GOP has attempted to restrict access to Medicaid by allowing states to impose onerous work requirements on Medicaid coverage, trying to impose per capita limits on Medicaid funding, and repeatedly proposing legislation that would end Medicaid expansion.
  • Restricting Access To Medicaid Threatens Lives And Impedes States’ Ability To Respond To The Opioid Epidemic. Four in 10 Americans with an opioid use disorder relies on Medicaid for access to treatment and life-saving overdose reversal medication. Restricting access to Medicaid puts people’s lives at risk and deprives states of funding and resources they depend on to fight the epidemic.

A TRUMP-GOP LAWSUIT COULD OVERTURN THE AFFORDABLE CARE ACT, WHICH PROTECTS PEOPLE WITH SUBSTANCE USE DISORDER

  • Because Of The Affordable Care Act, Insurance Companies Can No Longer Deny Coverage Or Charge More Because Of Pre-Existing Conditions. The Affordable Care Act prevents insurance companies from denying someone coverage or charging them more because of a health problem they had before the date that new health coverage starts. It also prevents insurance companies from rescinding or canceling someone’s coverage arbitrarily if they get sick.
  • The ACA Outlawed Medical Underwriting, The Practice That Let Insurance Companies Charge Sick People More. As the Brookings Institution summarizes, “The ACA outlawed medical underwriting, which had enabled insurance carriers to court the healthiest customers while denying coverage to people likely to need costly care. The ACA guaranteed that all applicants could buy insurance and that their premiums would not be adjusted for gender or personal characteristics other than age and smoking.”
  • The ACA Requires That Insurance Companies Cover Mental Health And Substance Use Disorder Services, And Paved The Way For Medicaid Expansion, Which Helps People Access Services For Substance Use disorders. The Affordable Care Act established ten essential health benefits, including mental health services, substance use disorder services, and prescription drug coverage, that insurance companies are required to cover. Without these protections, people in the individual market could be on their own — before the ACA, 45 percent of individual market plans did not cover substance use disorder services, and 38 percent of plans did not include mental health services.  The ACA also enabled states to expand Medicaid, which has helped people with substance use disorders and mental illness receive treatment. Recent research finds that Medicaid expanding reduced the unmet need for substance use treatment by 18.3 percent.

TRUMP-GOP JUNK INSURANCE PLANS OFTEN EXCLUDE COVERAGE FOR PRE-EXISTING CONDITIONS, MENTAL HEALTH CARE AND MORE

Short-Term Plans May Exclude Coverage For Pre-Existing Conditions. “Policyholders who get sick may be investigated by the insurer to determine whether the newly-diagnosed condition could be considered pre-existing and so excluded from coverage.” [Kaiser Family Foundation, 2/9/18]

  • As Many As 130 Million Nonelderly Americans Have A Pre-Existing Condition. [Center for American Progress, 4/5/17]
  • 1 in 4 Children Would Be Impacted If Insurance Companies Could Deny Or Charge More Because Of A Pre-Existing Condition. [Center for American Progress, 4/5/17]

Short-Term Junk Plans Can Refuse To Cover Essential Health Benefits. “Typical short-term policies do not cover maternity care, prescription drugs, mental health care, preventive care, and other essential benefits, and may limit coverage in other ways.” [Kaiser Family Foundation, 2/9/18]

Under Many Short-Term Junk Plans, Benefits Are Capped At $1 Million Or Less. Short-term plans can impose lifetime and annual limits –  “for example, many policies cap covered benefits at $1 million or less.” [Kaiser Family Foundation, 2/9/18]

Short-Term Junk Plans Can Retroactively Cancel Coverage After Patients File Claims. “Individuals in [short-term (STLDI)] plans would be at risk for rescission. Rescissions are retroactive cancellations of coverage, often occurring after individuals file claims due to medical necessity. While enrollees in ACA coverage cannot have their policy retroactively cancelled, enrollees in STLDI plans can.” [Wakely/ACAP, April 2018]