Individuals in Medicaid Deserve Care That is Appropriate and Responsible in its Execution Act

Floor Speech

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Ms. CASTOR of Florida. Mr. Speaker, I have a motion to recommit at the desk.

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Ms. CASTOR of Florida. I am opposed in its current form.

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Ms. CASTOR of Florida. Mr. Speaker, this is the final amendment to the bill. It will not kill the bill or send it back to committee. If adopted, the bill will immediately proceed to passage, as amended.

Mr. Speaker, the House has been debating legislation to combat the opioid epidemic. While many of the bills we heard last week and this week are fine, together they fail to meet the challenge of this very serious public health crisis where in America today, we are losing about 40,000 lives a year due to opioid addiction.

Now, in the Energy and Commerce Committee over the past few months, we have had numerous hearings and heard from all sorts of experts and families and the DEA and health providers. And then back home, families have been educating us on the challenges of dealing with opioid addiction.

Families and public health experts and the medical community, they have reached a consensus that we need a more comprehensive approach to tackle the opioid epidemic that includes prevention, community-based treatment, and integrated recovery plans. But it is very difficult for us to be proactive in a meaningful way on the opioid crisis when the Republicans and the White House continue to press us backwards when it comes to access to affordable healthcare.

Just last week, the Trump administration launched a new attack on Americans with preexisting conditions, and that includes families struggling with opioid addiction. President Trump and the GOP asked a Federal court to strike down the protection that prevents insurance companies from denying coverage or charging more for a preexisting condition.

This would be a devastating blow to those suffering from addiction, not to mention cancer or diabetes or a heart condition or more. This would leave more families without insurance and more families without addiction treatment.

President Trump and the GOP were not successful last year in ripping health coverage away from families across this country through legislation, so now they are trying to do this through the court system: take away the guarantee of health coverage for millions of Americans with preexisting conditions. This is wrong and it will make the opioid epidemic worse. Instead, we should be working together to develop and fund a comprehensive robust plan to combat and treat addiction.

Mr. Speaker, this is why I am proposing an amendment to strengthen the underlying bill. My amendment, most importantly, makes the 5-year limited repeal of the IMD exclusion for individuals with substance use disorders contingent on the State expanding Medicaid. It is based on the most up-to-date research and everything we know about how important Medicaid and Medicaid expansion is to treating opioid addiction.

Mr. Speaker, Medicaid is central to treating addiction, because families can get early intervention and treatment, including the important medical-assisted treatment. In fact, Medicaid serves four out of ten of nonelderly adults with opioid addiction.

According to a 2016 study by the National Council on Behavioral Health, about 1.6 million people with substance use disorders now have coverage because they live in one of the 31 States at the time that expanded Medicaid. So they are more likely to receive treatment, including access to naloxone and other drugs that help them stay off the opioids.

The Agency for Healthcare Research and Quality highlighted the importance of Medicaid expansion in increasing insurance coverage among people with opioid use disorders just recently. They found that the share of hospitalizations in which the patient was uninsured fell dramatically in States that had expanded Medicaid, from over 13 percent in 2013 to just 2.9 percent 2 years later after those States expanded Medicaid. The steep decline indicates that many uninsured people coping with opioid addiction gained coverage through Medicaid expansion.

Medicaid is part of the solution to the opioid crisis, and Republicans should not irresponsibly press to cut millions of Americans, take away their lifeline as they propose massive cuts again to Medicaid.

The Republican budget came out just yesterday. Surprise, surprise. Again, they go after families who rely on Medicaid, not just Medicaid expansion that has been so important to treating folks who suffer from addiction, but families, children, our neighbors with disabilities, folks that rely on skilled nursing care, the Republican budget released yesterday says $1.5 trillion in cuts to those families. That is not going to help solve the opioid epidemic.

Republicans in Congress cannot, on one hand, say we are facing up to the addiction crisis, and on the other say we are taking away your healthcare, whether it is Medicaid or preexisting conditions.

Mr. Speaker, I urge approval of my motion, and I yield back the balance of my time.

Mrs. MIMI WALTERS of California. Mr. Speaker, I withdraw my point of order.

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Ms. CASTOR of Florida. Mr. Speaker, on that I demand the yeas and nays.

The yeas and nays were ordered.

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