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Trump’s War On Medicaid, Health Care Sabotage Undermines Fight Against Opioid Addiction

By April 23, 2019April 25th, 2019No Comments

Ahead of President Trump’s Appearance At A Summit on Opioid Abuse in Atlanta, It’s Clear His War On Health Care Is Hurting America’s Fight Against Opioid Addiction

Washington, DC – President Trump is set to address to the Rx Drug Abuse and Heroin Summit on Wednesday in Atlanta, but his visit is overshadowed by his administration’s relentless war on America’s health care and his relentless effort to strip protections for Americans with pre-existing conditions, including those with opioid use disorder. In his repeated attempts to gut Medicaid, Trump is cutting off a lifeline for people suffering from opioid addiction, and his Texas lawsuit to overturn the Affordable Care Act would gut protections for Americans with substance abuse disorder.

Ahead of his upcoming speech on the opioid epidemic, Protect Our Care chair Leslie Dach issued the following statement:

“Let’s be clear: Instead of waging a war on the opioid crisis, President Trump has waged a war on our health care that is hurting people with opioid use disorder. His drastic cuts to Medicaid, his lawsuit in Texas to dismantle the health care system and his support for junk insurance plans will take away care from millions. If there are two things that Americans agree on, it’s that the opioid crisis is serious and that pre-existing conditions protections need to be upheld; neither of which the Trump administration seems concerned about.”

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 proposinglegislation that would end Medicaid expansion. The Trump administration’s budget for 2020 calls for  $1.5 trillion in cuts to Medicaid, and would impose a nationwide Medicaid work requirement.

  • Restricting Access To Medicaid Threatens Lives And Impedes States’ Ability To Respond To The Opioid Epidemic. Four in 10Americans 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.

  • Among Those With Opioid Addiction, People Covered Through Medicaid Are More Than Twice As Likely As Those With Private Insurance Or No Insurance To Receive Treatment. In 2016, 43 percent of people who had substance use disorders received treatment when they were covered through Medicaid, significantly higher than the 21 percent of those privately insured who received treatment and 23 percent of those who were uninsured and received treatment.

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 rescindingor 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]