As drug overdoses kill more Americans under 50 than any other cause, Senate Majority Leader Mitch McConnell and his fellow Republicans realize that cutting support for addiction treatment would look like a big mistake.
So, they may soften their cuts to Medicaid and private insurance coverage by giving states grants to combat the opioid plague, according to reports dribbling out of a small group of male GOP senators who have been meeting in secret to draft a replacement for the Affordable Care Act.
Grants are no substitute, however. Grants run out, while insurance is supposed to be there when you need it.
Republicans want to end the Medicaid expansion that increased access to addiction treatment in Kentucky like nothing ever before. As deadly and cruel as the opioid epidemic has been, the pain would be worse without the dramatic expansion in access to treatment that the ACA brought in 2014.
Not only could more Kentuckians afford treatment, the depth and variety of treatment options multiplied because providers in public and private sectors knew there would be money to pay them.
Treatment services increased by 740 percent in Kentucky in the first 30 months of expanded Medicaid, equal to more than 40,000 treatment services a year.
Also, insurers were required to cover addiction treatment. Before the ACA, 34 percent of individual policies failed to pay for treating drug use disorders. Republicans seem determined to again let insurers deny treatment for addiction and other diseases.
McConnell reportedly wants a vote by July 4 on a bill that would harm millions of Americans, and he wants it without public discussion.
Not only is the public being excluded from having input or being part of the debate, so are most of the Republicans and all of the Democrats in the Senate. The health-care bill is being kept under such tight wraps that Sen. Rand Paul quipped to an NBC News crew that if it scored a draft, “will you send me a copy?”
McConnell is hoping that by limiting public scrutiny he can limit damage to Republicans seeking re-election next year. A recent poll found that only 8 percent of Americans think the Senate should pass the House plan, the one that President Donald Trump celebrated in May but last week called “mean.”
During his campaign, Trump promised to end the opioid crisis and said no one would lose health coverage.
While McConnell worries about survival of his Republican majority, many of his constituents worry about survival. They worry about keeping their addicted sons, daughters, spouses and parents alive. Kentucky tied Ohio for the nation’s third highest rate of overdose deaths in 2015, the latest year for which official numbers are available.
The addiction epidemic is fueling other crises. Kentucky had the highest rate of new hepatitis C infections from 2008 to 2015 and because of intravenous drug use is at risk of an HIV outbreak.
A quarter of Kentucky adults say they know someone who has abused prescription pain medicine and 16 percent know someone who is using heroin. Adults who can’t work because of drug use leave families in need.
Public health commissioner Dr. Hiram Polk Jr. calls drug use disorders Kentucky’s “number one public health crisis.”
It’s no time to gut the expanded treatment that is the only lifeline for so many Kentuckians.