Wednesday, January 11, 2017

Pennsylvania’s Medicaid Program Is a Vital Tool in Fighting the Opioid Crisis

From Community Legal Services


The number of Pennsylvanians lost to overdose is at record highs. In 2015, over 3,000 Pennsylvanians died from heroin and opioid-related overdoses.  That number is expected to increase for 2016.   The General Assembly and the Wolf Administration have recognized the problem by working together on bipartisan policies to address the opioid crisis.

Pennsylvania has another vital tool in fighting the opioid crisis:  Medicaid.  Medicaid provides critically important health care to Pennsylvanians who need substance use treatment.  Yet Congress is considering cuts to Medicaid that would reverse the progress that Pennsylvania has made in addressing the opioid crisis.

Medicaid is vital for many people with substance use disorders.  The Medicaid program is the largest payer of behavioral health services, including treatment for substance use disorders like opioid addiction.  Over 20% of all people dealing with substance use disorders are covered by Medicaid.  In 2015, Pennsylvania expanded Medicaid under to Affordable Care Act to cover most lower income Pennsylvanians.  In that first year alone, Pennsylvania’s Medicaid expansion provided drug and alcohol treatment for over 60,000 people who might otherwise have gone without care. In response to the opioid crisis, Pennsylvania has opened 50 centers across the Commonwealth that are focused on helping Medicaid enrollees who are struggling with opioid addiction. The centers help Pennsylvanians get back on their feet by connecting them to physical and behavioral health providers, community-based care navigators, and community-based resources such as employment and housing.

Reducing funding for Medicaid would put people at risk and take Pennsylvania backward in addressing the opioid crisis.  Congress is considering new limits on federal funding for Pennsylvania’s Medicaid program.  Congress is also weighing eliminating Medicaid expansion altogether by repealing the Affordable Care Act.  These cuts would reduce access to treatment and overdose prevention services for Pennsylvanians who need help.  The cuts would force Pennsylvania to limit the types of treatment services that it provides and/or limit the number of people who can get treatment.  The cuts would reverse the progress that Pennsylvania has made in addressing the opioid crisis.

Adding barriers to Medicaid could create a treatment crisis for people with substance use disorders.  Faced with funding cuts, Pennsylvania would be forced to implement barriers to accessing care.  These barriers could be reminiscent of Pennsylvania’s short-lived Healthy Pennsylvania Medicaid initiative, which imposed new barriers to behavioral health care in 2014.  Thousands of people suddenly lost coverage for behavioral health treatment because they were placed in a limited benefits package that did not meet their health care needs.  Sudden loss of treatment tied the hands of providers and put patients’ health at risk.  In the midst of an opioid crisis, prevention and treatment of substance use disorders is too important for any disruption in care.