The Senate health care bill would slash Medicaid funding and waive essential benefit requirements that include addiction coverage, severely cutting back coverage most Americans now have for opioid addiction treatment.
The changes would leave 22 million more Americans without health insurance by 2026, according to a Congressional Budget Office assessment. Senate Majority Leader Mitch McConnell (R-Ky.), lacking support to move the bill forward, announced Tuesday he would delay the Senate vote until after the July 4 recess.
Some Republican dissenters pointed to the lack of opioid-treatment funding ― a one-time $2 billion grant instead of $4.5 billion in yearly behavioral health coverage, which includes addiction coverage ― as a point of contention.
A study published Tuesday in the journal Drug and Alcohol Dependence backs up those who are critical of this aspect of the health care bill by quantifying just how bad defunding addiction treatment would be. Providing medical care to people with opioid use disorder could cut deaths from opioids by as much as one-third, the study says.
“Treatment works and unless you pay for treatment, people aren’t going to get it,” Dr. Katherine Watkins, lead author of the study and a physician scientist at Rand Corp., told HuffPost.
“By covering substance abuse treatment and making it an essential health benefit, it really opens up the possibility for people who want treatment to not have the financial barriers to treatment,” Watkins said.
People are going to die without treatment.
Dr. Katherine Watkins, Rand Corp.
The study analyzed medical records of 32,422 patients in the Veterans Administration health system, who were identified as having opioid use disorder from October 2006 to September 2007. The researchers identified seven measures of quality medical treatment for patients with opioid use disorder and determined that three of those measures were associated with a much lower risk of death from opioids.
(Since veterans tend to skew male, older and lower on the socioeconomic ladder, results in private-care systems may be different.)
Not being prescribed opioids or benzodiazepines ― common pain-control treatments ― if the patient had a documented opioid use disorder, was associated with a 29-percent decrease in mortality, receiving psychosocial treatment was associated with a 24-percent drop in mortality, and having quarterly physician visits was associated with an 18-percent reduction in mortality.
Notably, there was no association between lower risk of death among patients who received medication-assisted opioid treatment, another measure of quality medical care.
“I was very surprised about that,” Watkins said. “Medication-assisted treatment is definitely associated with good outcomes. You’re more likely to have and hold a job. You are more likely to be abstinent. You are less likely to be involved in the criminal justice system. There’s no question in my mind that medication-assisted treatment is a useful and helpful treatment.”
The study didn’t distinguish between people who started and stopped medication treatment, and those who adhered to it long-term. Watkins speculated that the mortality risks of on-again, off-again medication could have canceled out the benefits of consistent treatment.
The study comes at a crucial time, given recent reports that the opioid crisis is deepening. According to a New York Times Upshot analysis this month, overdose deaths are projected to top 59,000 in 2016, and worsen in 2017.
Senate Republicans might want to consider those statistics when they return after the July 4 recess to vote on the health care bill.
“People are going to die without treatment,” Watkins stressed. “Without funding for treatment, people are not going to get it and that’s going to lead to all the negative consequences of opioid addiction, like increased crime, family destruction, overdoses and [rising] health care costs.”