WASHINGTON, D.C. – Today, the House of Representatives is expected to vote on a Congressional Republican proposal that would force millions of Americans to pay more for less care, and would put millions of people at risk of losing their health care coverage, including those struggling with an opioid addiction or other substance use disorders.
The House proposal weakens consumer protections in the private insurance market, reduces tax credits, and turns Medicaid into a per capita cap or block grant system, which will lead to cuts in health care services.
There are also news reports that the White House is cutting last minute deals with Speaker Paul Ryan and House Republicans, including a deal that could repeal a requirement that insurance companies provide guaranteed coverage for substance abuse treatment, mental health, and other essential benefits. This would mean that individuals struggling with opioid abuse may not be able to find a health plan that would cover their treatment and could be forced to pay out-of-pocket to get the care they need.
U.S. Senator Tammy Baldwin highlighted how the Congressional Republican proposal would undermine the recent bipartisan progress to address the opioid epidemic in Wisconsin.
“By weakening consumer protections in the private insurance market, reducing tax credits, and ending Medicaid as we know it with caps and cuts, the House Republican proposal will dramatically increase and shift health costs on to Wisconsin and our families for substance use and mental health services,” said Senator Baldwin. “Now, news reports suggest that House Republicans are working at the last minute to make a bad bill worse by repealing a requirement that insurance companies provide guaranteed coverage for substance abuse treatment.”
Wisconsin is facing an opioid epidemic that continues to grow at an alarming rate. The rate of opioid overdose deaths in the state nearly doubled from 2006 to 2015, and opioid-related deaths are now a leading cause of injury deaths in Wisconsin. Recent statistics show that in 2015, almost 900 Wisconsinites died from overdoses, and total overdose deaths have increased nearly 70 percent since 2005.
The House Republican proposal removes the requirement that insurers provide minimum levels of coverage for the cost of covered services, which will force consumers to pay more out-of-pocket for their health care needs. Before the Affordable Care Act (ACA), one-third of individual market health plans didn’t cover substance use disorder services, and a fifth of those plans didn’t cover mental health. The ACA made these benefits mandatory by establishing minimum standards for “essential health benefits.”
The House Republican proposal will also repeal the ACA’s premium tax credits and cost-sharing subsidies that help lower premiums and out-of-pocket costs for thousands of Wisconsinites, including for people with substance use disorders and mental illness.
In addition, Medicaid is the single largest payer of substance use disorder services in the nation and one-third of the medication-assisted treatment administered for opioid and other substance use disorders in the country. The House Republican proposal would fundamentally change Medicaid into a per capita cap system and result in irreparable cuts to the program. A per capita cap or block grant system, by design, would not be able to respond to new public health threats, like a spike in opioid-related overdoses, forcing states to shoulder the burden of any additional costs.
“We’ve finally made bipartisan progress on fighting the opioid epidemic, but TrumpCare will take us backwards and make this crisis worse. The House Republican proposal will pull the rug out from under our efforts and put too many people in Wisconsin at risk of losing coverage for substance use disorder prevention, treatment, and recovery services. Today the House will be voting on legislation that could translate into a death spiral for those with opioid use disorders,” said Senator Baldwin.