Addiction Experts Oppose Better Care Reconciliation Act (BCRA).
Washington, DC –(ENEWSPF)—July 6, 2017. Our nation’s escalating opioid crisis – with more than 144 people dying every day from overdose – will not abate without access to comprehensive substance use disorder treatment in private insurance and Medicaid. The Senate’s version of healthcare repeal would cripple national efforts to address this public health epidemic.
No time-limited infusion of federal dollars for addiction treatment can fill the gaping coverage and financing holes, meet the unmet need for substance use treatment, or prevent the significant disruption in health care delivery that will result under the enactment of the Better Care Reconciliation Act (BCRA).
Research has clearly shown that substance use disorders are complex, chronic medical conditions, best treated with comprehensive and integrated care. Until the passage of the Affordable Care Act, substance use disorders were financed and treated separately from the rest of healthcare, largely through government funded block grants. This produced a truly segregated, seriously under-resourced system that contributed to the current addiction epidemic in this country and perpetuated discrimination.
Separate funding to address the opioid crisis will not meet the overarching healthcare needs of patients struggling with addiction, who often have numerous co-occurring health problems that must also be addressed. It will not adequately support prevention for SUDs, nor the long-term recovery management that is indicated for chronic medical illnesses.
The non-partisan Congressional Budget Office estimates that BCRA would cut Medicaid funding by $772 billion, as the bill would impose caps on federal Medicaid funds and end the Medicaid expansion. These changes would mean that millions of people with substance use disorders would lose coverage for lifesaving treatment. Approximately half of Medicaid enrollees have substance use or mental health disorders, and Medicaid pays for approximately 30% of the cost of medications to treat addiction. Countless people who are currently in treatment and on the road to recovery would lose access to the critical services needed to maintain their health. The rate of opioid fatality would sharply rise.
The BCRA will end significant progress in creating a stable and sustainable financing structure for substance use treatment through Medicaid and private insurance, stripping away addiction coverage from millions of Americans who desperately need it. Further, it would reinstate discriminatory coverage of substance use treatment by allowing states to waive such benefits in Essential Health Benefit-based plans and reinstate underwriting for pre-existing conditions making coverage for addiction treatment unaffordable for many Americans.
The Senate healthcare repeal plan, which would leave 22 million Americans uninsured, is untenable. It will be particularly devastating to millions of Americans who have complex or pre-existing conditions, including substance use disorders. If enacted, the BCRA would undercut our national efforts to stem the opioid crisis, dramatically cutting funding for critical life-saving treatments.
The undersigned individuals and institutions represent leaders in the field of addiction care, research and policy. We urge Congress to reject this harmful legislation. The devastation caused by the Senate bill will not be ameliorated by a short-term infusion of grant funding to address the opioid epidemic.
Paul Samuels, JD, President/Director, Legal Action Center
Michael Botticelli, Executive Director, Grayken Center for Addiction Medicine, Boston Medical Center; Former Director, White House Office of National Drug Control Policy
Patty McCarthy Metcalf, Executive Director, Faces & Voices of Recovery
Susan P. Brown, Vice President and Secretary-Treasurer; Director of Finance and Administration, The National Center on Addiction and Substance Abuse
Chuck Ingoglia, Sr. Vice President, Public Policy and Practice Improvement, National Council for Behavioral Health
Roberta Carlin, M.S., J.D., Executive Director, American Association on Health and Disability
Emalie Huriaux, MPH, Director of Federal & State Affairs, Project Information Chair, California Hepatitis Alliance
Pamela F. Rodriguez, President & CEO, TASC, Inc. (Treatment Alternatives for Safe Communities)
Kathleen O’Brien, PhD, President, The Maryland Addictions Directors Council
Hollis Pickett, President, Local Area Support For Hepatitis (LASH)
Tim Clement, Senior Policy Advisor, The Kennedy Forum
Alison Oliveto, Ph.D., Program Director, Clinical Trials Innovation Unit, Translational Research Institute
Professor and Vice Chair for Research, Psychiatry and Behavioral Sciences Director, Center for Addiction Research, University of Arkansas for Medical Sciences
David C. Perlman, MD, Professor of Medicine and Chief, Infectious Diseases, Icahn School of Medicine at Mount Sinai, Chief, Infectious Diseases, Mount Sinai Beth Israel
Lois Petty, SEP Site Manager, SLO Bangers Syringe Exchange and Overdose Prevention Program
Richard Hawks, PhD, Deputy Director, Division of Treatment Research and Development, Retired, National Institute on Drug Abuse, NIH
Marguerite Beiser, ANP-BC, Director of HCV Services, Boston Health Care for the Homeless Program
Avik Chatterjee, MD, Physician, Boston Health Care for the Homeless Program, Instructor, Harvard Medical School
Jo L. Sotheran, PhD, MARS Project
Scott Burris, Professor and Director, Center for Public Health Law Research, Temple University Beasley School of Law
Lucy M. Candib, M.D., Professor, Department of Family Medicine and Community Health
Henry R. Kranzler, M.D., Professor of Psychiatry. Director, Center for Studies of Addiction, University of Pennsylvania, Perelman School of Medicine
Elizabeth Spradley, Nurse, Johns Hopkins Hospital
Ronald Manderscheid, Executive Director NACBHDD – National Association of County Behavioral Health and Developmental Disability Directors, NARMH – National Association for Rural Mental Health
Marcia Lee Taylor, Chief Policy Officer, Partnership for Drug-Free Kids
Mark W. Parrino, M.P.A., President, American Association for the Treatment of Opioid Dependence (AATOD)
Daniel Raymond, Deputy Director of Planning and Policy, Harm Reduction Coalition
Alice Dembner, Program Director, Substance Use Disorders and Justice- Involved Populations Community Catalyst
Gary Mendell, Founder and CEO, Shatterproof
Robert Heimer, PhD, Professor of Epidemiology, Yale School of Public Health, Center for Interdisciplinary Research on AIDS
Shira Shavit, MD, Executive Director, Transitions Clinic Network, Associate Clinical Professor, University of California, San Francisco
Brendan Saloner, PhD, Assistant Professor of Health Policy and Management, John Hopkins Bloomberg School of Public Health
Thomas Miller, President, Association for Ambulatory Behavioral Healthcare
Sally Bachofer, MD, Associate Professor, Department of Family & Community Medicine, University of New Mexico School of Medicine
Mishka Terplan, Professor Departments Obstetrics and Gynecology and Psychiatry, Virginia Commonwealth University
Diane C. Feirman, CAE, Public Affairs Senior Director, American Group Psychotherapy Association
Aaron Arnold, Executive Director, Prevention Point Pittsburgh
Demetrius Marcoulides, RN MSN, Founder & Director, Nursing Students for Harm Reduction
Colleen M. Grogan, Professor, School of Social Service Administration, University of Chicago
James K. Rowlett, Ph.D., Professor, University of Mississippi Medical Center
John Cawley, Professor, Department of Policy Analysis and Management, Professor, Department of Economics, Co-Director, Institute on Health Economics, Health Behaviors and Disparities, Cornell University
Tricia Wright, MD MS FACOG FASAM, Associate Professor Department of Obstetrics, Gynecology and Women’s Health. Clinical Associate Professor, Department of Psychiatry, University of Hawaii John A. Burns School of Medicine
Kim Brown RN, President, QC Harm Reduction
Tom Coderre, Senior Advisor, Altarum Institute
Victor Capoccia, Former Team Leader, Addiction Prevention and Treatment, Robert Wood Johnson Foundation
Kelly J. Clark, MD, MBA, President, American Society of Addiction Medicine
Thomas McLellan, PhD, Founder, Treatment Research Institute; Former Deputy Director, White House Office of National Drug Control Policy
Kathryn Cates-Wessel, CEO, American Academy of Addiction Psychiatry
Grant Smith, Deputy Director, National Affairs of the Drug Policy Alliance
Cynthia Moreno Tuohy, NCAC II, CDC III, SAP, Executive Director, NAADAC, the Association for Addiction Professionals
Jim Hood, Co-Founder and CEO; Greg Williams, Co-Founder and Executive Vice President, Facing Addiction
Wendy Armstrong, MD, Chair of the Board, HIV Medicine Association
Dr. Nancy Rosen Cohen, Executive Director, Maryland Chapter National Council on Alcoholism and Drug Dependence
Wayne Wirta, President/ CEO, NCADD-NJ
Derek Hodel, Interim Executive Director, Drug Policy Alliance
Jerry Douglas MD, Chief Medical Officer, Hillside Health Center
Hannah Watson MD, Maternal Child and Reproductive Health Fellow, University of New Mexico Hospital
Keith Brown, MPH, Director, Health & Harm Reduction, Katal Center for Health, Equity, and Justice
Annie Herriott, M.S., MSW, Doctoral Candidate, Boston University School of Social Work
Amanda Latimore, PhD, Director of Social Epidemiology and Evaluation, Behavioral Health System Baltimore
Bruce G. Trigg, MD, Addiction medicine and public health consultant
Paul Pentel, Director, Division of Clinical Pharmacology, Hennepin County Medical Center, Mpls, MN
Matt Slonaker, JD, Executive Director, Utah Health Policy Project
Justin Luke Riley, President, Young People in Recovery
Orlando Chavez, Health Systems Navigator, HIV/HepC Prevention and Harm Reduction Services, GLIDE
Jason Grebely BSc PhD, Associate Professor, Kirby Institute, UNSW Australia; NHMRC Career Development Fellow; President, International Network on Hepatitis in Substance Users (INHSU)
Cyndee Clay, Executive Director, HIPS
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