But this bill is not worth celebrating. It’s an illustration of how little Republicans care about the opioid crisis.
To be fair, there are some Republicans who care. And don’t get me wrong: This isn’t a bad bill, per se. The Senate bill is a bipartisan project with plenty of provisions that could do good, including grant programs that would make it easier for doctors to jump through all the hoops necessary to prescribe addiction treatment drugs. It also tinkers with federal drug enforcement agencies to better equip them in the fight against dangerous synthetic opioids — in particular the mass killer, fentanyl. In total, the bill could add some $8 billion in new funding over five years if fully implemented, according to an early Congressional Budget Office estimate.
These are all worthy reforms, and no doubt Republicans will use them in their campaigns to demonstrate that the GOP is still capable of working across the aisle and passing major legislation. But don’t let them off the hook so easily. If Republicans really wanted to prove that they can govern, they’d have to go much bigger.
Health policy experts say the epidemic calls for tens of billions of dollars — perhaps even more than $100 billion. That would include expanding health care to make sure that Americans with opioid use disorder are covered and have access to medication-assisted treatment, the only treatment proven to effectively address the addiction. Last year, of the nearly 20 million people who needed the therapy, 94 percent didn’t receive it — many because they couldn’t afford it.
Republicans surely recognize this. The issue came up last year when the hard-liners attempted to repeal the Affordable Care Act, thereby threatening to throw health care for many of those addicted to opioids under the bus. In an attempt to keep the ACA repeal from making the opioid epidemic even worse — and to woo votes from moderate conservative voters — Republican leaders offered $45 billion to address the crisis.
But even that, experts warned, was drastically insufficient in the face of an ACA repeal. And yet, most Republicans voted for it. Some even tried justifying their votes with silly arguments that access to health care for low-income Americans was exacerbating the epidemic.
And let’s not forget the politics that mucked up the current legislation in the Senate. When Republicans finally got around to crafting the opioid package, it stalled after it was revealed that one provision of the bill awarding grants to advocacy organization was so narrowly worded that only one group was eligible for funding: Addiction Policy Forum, which has strong ties to pharmaceutical lobbying groups. Democrats eventually forced Republicans to strip the language from the bill.
That brings us to the most damning detail against Republicans — the timing. That is, they’re focusing on the issue almost two years after they gained total control of the government and, conveniently, a few months before their midterm elections.
Let’s look at some of the other legislation they tackled first: a tax cut going mostly to wealthy businesses that exploded the national deficit; a string of legislation attempting to undo health care coverage gains under the ACA, including multiple attempts to slash Medicaid spending going to low-income Americans; and a seemingly endless series of spending deals that included a paltry $3.3 billion for the opioid crisis.
Meanwhile, the Trump administration initiated an all-out assault on health care for poor people, destabilizing ACA marketplaces and issuing a regulation that allows states to impose working requirements on Medicaid recipients. Just last week, more than 4,300 people in Arkansas lost their eligibility for Medicaid due to the newly imposed requirements.
Fixing this crisis is going to take a firm commitment to expanding access to health care and a lot of money sustained over a long period of time. Public health experts call for an effort similar to that spurred by Congress in the ‘90s to get the HIV/AIDS epidemic under control. For reference, consider that in the last five years alone, we spent more than $100 billion domestically as part of our fight against HIV/AIDS, which has helped to reduce deaths from the disease to about 6,500 in 2016.
The opioid epidemic, by contrast, claimed an estimated 50,000 lives last year alone — about the same number of deaths due to HIV/AIDS during the disease’s peak in 1995. Given Congress’s response, it’s only going to get worse.
So forgive the bitterness toward Republicans in their moment of victory. They may want to feel good about this bill, but it is not the bold strategy we need. In truth, it’s pretty pathetic.