Levin Opening Statement at Health Subcommittee Hearing on Removing Barriers to Prevent and Treat Opioid Abuse and Dependence in Medicare
Feb 6, 2018
(As prepared for delivery)
Mr. Chairman, the opioid epidemic is an enormous societal problem that demands a concerted effort at every level of government. The death toll is astonishing. 91 Americans die every day from an opioid overdose, with 5 dying every single day in my home-state of Michigan alone. We have to stop this killer.
Despite the urgency of this crisis, it is increasingly clear that although President Trump has declared a public health emergency on paper, to date the Administration has taken no significant steps to address it. Instead, the President and his allies in Congress have fought aggressively to take us backwards.
Last year, President Trump proposed a budget that would radically alter the Medicaid program, while slashing its funding by $1.3 trillion. Medicaid is the largest payer for behavioral health services in the United States. It funds detoxification, maintenance therapy, medication assisted treatment, and other crucial services. We cannot claim that we are serious about addressing the opioid crisis on the one hand while gutting one of the country’s most important sources of treatment on the other.
These attacks come on the heels of an eight-year effort by this Congress to roll back the Affordable Care Act. Among the many devastating provisions of the repeal legislation passed by the House last year include the unraveling of federal consumer protections through state waivers. The bill would have allowed insurers to discriminate against patients with opioid dependence, while potentially eliminating behavioral health and substance abuse treatment as essential health benefits.
And, at this crucial time, the Administration has also attacked the Office of National Drug Control Policy, which for decades has helped fight drug abuse in this country. Last year, we fought against the Administration’s efforts to eliminate all funding for the Drug-Free Community program, an effective, multi-sector community based drug prevention program that Senator Portman and I created in 1996. This year, we hear once again that the Trump Administration intends to propose undercutting the Office by eliminating its oversight of drug control and prevention programs. Moreover, in a particularly revealing action, the Administration attempted to place a 24-year old with no relevant experience in the second highest position at the Office.
A coordinated, federal response to the opioid crisis is possible, but it will require a dramatic change of course by Congress and the Trump Administration. There are a number of proposals that deserve our consideration. For example, Medicare generally covers behavioral health and substance abuse, but does not provide comprehensive coverage of opioid treatment plans, including the use of methadone to treat opioid dependence. Committee Democrats have introduced legislation to close this gap, and I look forward to hearing from our witnesses about this issue.
Moreover, we must also take immediate steps to ensure that we are effectively implementing programs that prevent bad actors from flooding our communities with unnecessary prescriptions. In Michigan, a state of less than 10 million residents, more than 11 million opioid prescriptions are written annually. This is more than enough to provide each resident of my home state with a bottle of opioids each year. Addressing the pervasiveness of opioids will require a broad-based effort to revise clinical guidelines with the goal of improving provider behavior, leadership at the state and federal level to monitor harmful prescription and marketing practices, and other immediate steps that will reduce the prevalence of these drugs in our communities.
Mr. Chairman, the opioid crisis is the defining public health issue of this generation. The longer Congress and the Administration fail to act, the more of our loved ones we will lose to preventable tragedy.